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Alcohol is a causal factor in about 10% of breast cancer (BCa) cases, but awareness of this link is low. This study explored how to raise awareness and inform the development of an intervention using the COM-B model (capability, opportunity, motivation, behavior) framework. Eight online focus groups were conducted with 36 participants (6 expert stakeholders,and 30 women aged 40–65). Participants reflected on a package of information about alcohol and BCa and discussed how to impart this information and encourage women to reduce drinking. Thematic analysis of focus group transcripts was undertaken. Three themes were identified: understanding ineffective messaging; transitions and challenges; and message acceptability. Current health information about alcohol was perceived as judgmental and BCa was put down to chance. Mid-life consisted of many challenges that could lead to increased consumption, but menopause transition may be a key moment for alcohol reduction. Barriers and enablers to communicating risk information and encouraging alcohol reduction were mapped onto the COM-B model. Psychological capability (relating to knowledge), social opportunity (in the form of social pressure) and automatic motivation (relating to drinking to cope) were barriers to behavior change. These will be targeted in an alcohol reduction intervention. It is important to tailor information to women's experiences, taking into account the social benefits of drinking, and encourage the development of healthy coping strategies. Acceptable intervention messages may include personal stories, clear statistics, and suggest healthy alternatives to drinking. It is vital that messaging does not appear judgmental or patronizing. [ABSTRACT FROM AUTHOR]

This article presents a bibliometric analysis of research on COVID-19 health communication. We reviewed and analyzed 1,851 articles published in 170 peer-reviewed communication journals between January 2020 and November 2022, to identify key bibliometric information and major research topics in this rapidly expanding field of research. The distribution of countries indicates that the United States is the most productive country, and researchers from Spain, China and the United Kingdom also play an important role. Health Communication is the most influential journal in terms of research productivity and impact. The analysis of highly cited references demonstrates the interdisciplinary nature of this research field. The topics generated by structural topic modeling show that scholars have responded to a variety of issues in COVID-19 communication, encompassing different levels of health communication, the effects of information dissemination, the impact on the general public as well as vulnerable populations, health preventive behaviors and communication technologies. This study aims to enhance researchers' understanding of the current state of this research field and provide insights for future studies. [ABSTRACT FROM AUTHOR]

This survey study tested a two-level model of responses to conflicting advice about COVID-19 and examined the underlying emotional and cognitive mechanisms and the moderating role of advice source. Results showed that at the individual message level, advice evaluation was associated with advice outcomes. At the message group level, advice evaluation and outcomes were linked to perceived contradiction in content among the advice and the quantity of conflicting messages received, both directly and indirectly via recipients' emotions. Features of conflicting advice received primarily from impersonal sources had particularly strong associations with advice evaluation and outcomes. Implications for health communication were discussed. [ABSTRACT FROM AUTHOR]

Drawing upon construal level theory and regulatory fit literature, this research examined the effect of fit between humor and regulatory focus on audience engagement with health information on social media. The results of two studies showed that incongruity humor (vs. aggressive humor) induced greater social proximity between the source and the viewer, and humor type interacted with regulatory focus of a message to impact audience engagement. Specifically, incongruity humor paired with a prevention-focused message (vs. a promotion-focused message) resulted in greater content endorsement and health information engagement, whereas aggressive humor combined with a promotion-focused message (vs. a prevention-focused message) led to greater content endorsement. Results further identified processing fluency as a mediator of the fit effect on audience engagement. This research offers important theoretical and practical implications for public health interventions on social media. [ABSTRACT FROM AUTHOR]

Although it is clear that people experience physiological arousal in anticipation of news-focused medical consultations, our knowledge of people's experiences during and throughout these consultations is scarce. We examine interbeat interval responses (IBI) of patients and doctors during real-life medical consultations to understand how the experiences of both parties change throughout these encounters and whether they differ from each other. We also examine how the type of news delivered affects responses. We measured the IBI responses of patients and their oncologists throughout 102 consultations in which providers delivered news (classified as good, bad, or status quo) to patients about a recent computerized tomography scan. We observed two distinct phases of consultations: an initial "news" delivery phase and a subsequent "information" phase. During the news phase, on average, patients' IBI responses rapidly increased–indicating less autonomic arousal over time – whereas doctors' responses did not change over time. In contrast, throughout the information phase, on average, both patients' and doctors' responses remained steady. During the information phase, responses differed based on news type: on average, status quo consultations involved an increase in autonomic arousal, whereas good and bad news consultations involved no changes. Lastly, we observed significant variability in patients' responses during both phases. In sum, on average, patients (but not doctors) experience decreases in autonomic arousal while news is being delivered, suggesting that anticipatory distress regarding these consultations wanes quickly. However, our results also indicate that patients' experiences vary from one another, and future research should focus on factors explaining this variability. [ABSTRACT FROM AUTHOR]

As excessive sugar intake can result in obesity, type 2 diabetes, cardiovascular disease, and even cancer, this study aims to help people reduce sugar-sweetened beverages (SSBs) intake by exploring how gender-differed body image concerns influence people’s attitude and intention of SSBs consumption. A 2 (Participants’ gender: Male vs. Female) × 2 (Image gender: Male vs. Female) × 2 (Body image concern: Gaining weight vs. Losing muscle mass) online experiment was conducted to examine how the genderdiffered body image concerns influence people’s perception of SSBs. The findings showed that genderdiffered body image concerns exerted a significant influence across genders. Muscle mass loss-related information is more effective in generating negative attitude toward SSBs from males. Female imagerelated physical appearance change is more effective in generating negative attitude toward SSBs from females. This study also contributes to targeted communication by revealing that the quality-oriented targeted information outperformed the traditional quantity-oriented targeted information. Furthermore, this study complements EPPM by discovering the underlying mechanisms of female-targeted body image concern, such as perceived severity and response efficacy. [ABSTRACT FROM AUTHOR]

Health and fitness content intended to inspire people to live healthy lives (e.g. "fitspiration") has been linked to negative body image among girls and young women. Fitness influencers purport wanting to motivate healthy behaviors. This study seeks to examine the presence of strategies known to positively influence health behaviors (e.g. attitudes, self-efficacy) as well as of content known to have a negative influence (e.g. objectification) among fitness influencers. We conducted a content analysis (N = 441) of a random sample of one year of posts from four Instagram fitness influencers popular with girls and young women in the United States. The main analysis consisted of codes related to objectification, health promotion strategies, health-related content, and social engagement (i.e., likes). We found that fitness influencers included content that conveyed constructs previously found to positively influence health behaviors (e.g., attitudes and self-efficacy), but objectification was frequently present, in more than half of the posts. Additionally, we found that the presence of objectification in posts was negatively associated with likes, a form of social endorsement. We suggest health communicators aim to work in tandem with fitness influencers to include content that may motivate positive health behaviors and improve media literacy and that influencers aim to reduce the amount of objectifying content included in their posts. Our findings shed light on content being conveyed and possible insights into the negative effects associated with viewing such content. [ABSTRACT FROM AUTHOR]

Emerging communication technologies have seen the proliferation of misleading claims, untruthful narratives, and conspiracies. To understand how people perceive and act on different types of misinformation, this study examines how health misinformation varying in falsity (fabrication versus misuse) and evidence type (statistical versus narrative) affects sharing and verification intentions. Using COVID-19 vaccines as cases, the results from an online experiment showed that misused misinformation was perceived as less false than fabricated misinformation and resulted in higher sharing intentions for the issue of vaccine efficacy. Misinformation with narrative evidence, as compared to that with statistical evidence, was perceived as less false and led to lower verification intentions. These findings can be explained by psychological processes such as counterarguing and narrative engagement. Our results can help practitioners develop dedicated misinformation literacy programs. [ABSTRACT FROM AUTHOR]

Using the theory of motivated information management (TMIM), this study tested the effect of emerging adults' uncertainty discrepancy about COVID-19 vaccines on their intentions to vaccinate. In March and April of 2021, 424 emerging adult children reported on the likelihood of seeking or avoiding information from a parent about COVID-19 vaccines in response to their uncertainty discrepancy and negative emotions related to the vaccines. Results supported the direct and indirect effects specified by the TMIM. Moreover, the indirect effects of uncertainty discrepancy on intentions to vaccinate via the TMIM's explanatory mechanisms were conditioned by family conversation orientation. Consequently, the family communication environment may alter motivated information management in parent-child relationships. [ABSTRACT FROM AUTHOR]

This study analyzed the content, visual features, and audience engagement data of Instagram posts from two mental health organizations over one year (N = 725). For content features, mental health literacy and communicative strategies were examined. Posts that promoted knowledge of mental disorders and treatments, used information and community strategy were more likely to receive higher audience engagement. Visual features of demographic segments, visual composition, and visual framing topics were analyzed. Images that covered an unspecific population, used illustrated images, and focused on anti-stigma topical frames obtained more engagement. Theoretical contributions and practical applications regarding visual message design and management on social media to promote mental health are also offered. [ABSTRACT FROM AUTHOR]

As is the case in other situations of deep uncertainty, the unknowns related to the COVID-19 pandemic have aroused a great deal of attention in the media. Drawing insights both from mediatization theory and ignorance studies, we discuss the coverage of the AstraZeneca vaccine controversies to develop a new concept that we call the mediatization of ignorance. In doing so, we conceptualize the procedure through which unknowns become mediatized as a three-step process that results from a combination of logics from the areas of politics, health, and science/industry. Moreover, we argue that the mediatization of ignorance may have promoted vaccine hesitancy at a moment when vaccination was crucial for addressing the COVID19 pandemic. We conclude by suggesting the need to explore in further detail the role that ignorance plays not only in the management of the COVID-19 crisis but also in different areas of society. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, journalists were encouraged to convey uncertainty surrounding preliminary scientific evidence, including mentioning when research is unpublished or unverified by peer review. To understand how public audiences interpret this information, we conducted a mixed method study with U.S. adults. Participants read a news article about preprint COVID-19 vaccine research in early April 2021, just as the vaccine was becoming widely available to the U.S. public. We modified the article to test two ways of conveying uncertainty (hedging of scientific claims and mention of preprint status) in a 2 × 2 between-participants factorial design. To complement this, we collected open-ended data to assess participants' understanding of the concept of a scientific preprint. In all, participants who read hedged (vs. unhedged) versions of the article reported less favorable vaccine attitudes and intentions and found the scientists and news reporting less trustworthy. These effects were moderated by participants' epistemic beliefs and their preference for information about scientific uncertainty. However, there was no impact of describing the study as a preprint, and participants' qualitative responses indicated a limited understanding of the concept. We discuss implications of these findings for communicating initial scientific evidence to the public and we outline important next steps for research and theory-building. [ABSTRACT FROM AUTHOR]

Lack of knowledge from parents concerning the appropriate use of antimicrobials leads to poor treatment choices and mismanagement of antimicrobials for their children. Social marketing (SM) strategies have the potential to help parents access useful information on the appropriate use of antimicrobials. Still, its application in interventions targeting antimicrobial/antibiotic resistance awareness is minimal. This study explores the use of SM in antimicrobial/antibiotic awareness campaigns (AACs) to identify opportunities for SM approaches in developing future communication interventions targeting parents and children. We conduct a systematic review of interventions targeting parents and children between 2000 and 2022. Articles meeting the selection criteria were assessed against social marketing benchmark criteria (SMBC). We identified 6978 original records, 16 of which were included in the final review. None of the articles explicitly identified SM as part of their interventions. Twelve interventions (75%) included 1 to 4 (out of 8) benchmark criteria, while four (25%) had 5–8 benchmarks in their interventions. Of the interventions with less than four benchmark criteria, six studies (50%) reported a positive effect direction outcome, and six studies (50%) reported negative/no change direction on the outcome of interests. Meanwhile, all interventions with five or more SMBC resulted in a positive effect direction in their outcomes. In this review, the use of SM has shown promising results, indicating opportunities for future antimicrobial resistance (AMR) interventions that incorporate social marketing benchmark criteria to improve intervention outcomes. [ABSTRACT FROM AUTHOR]

In North America, stigma remains a significant barrier to treating obesity. Many candidates for medical weight management do not seek treatment, possibly related to anticipated and internalized stigma and weight bias. Pharmacologic treatment of obesity remains highly stigmatized, despite advances in drug development and medical weight management programs. People contemplating medical weight management are likely to see information about "diet pills" on social media sites, such as Twitter. However, Twitter has been found to contain false and stigmatizing information. This study examines a sample of 2170 Tweets to better understand the content through the lens of obesity stigma. Tweets were collected over a seven-day period containing general terms such as "diet pills," "weight loss pills," or "fat burner" using the Twitter advanced search option. The analysis revealed that almost 50% of Tweets containing "diet pills" contained stigmatizing language. The most common elements of stigma communication were taking personal blame for obesity and the perils associated with taking medications for weight loss. Further analysis revealed sub-themes such as profiting from social pressures to lose weight, distrust of physicians and the practice of obesity medicine, lack of efficacy of medications, and the use of social media to disseminate stigma. Most Tweets were from personal accounts followed by direct sales of weight loss supplements. The findings have potential implications for medically supervised weight management programs and may drive the need for more evidence-based social media messaging around obesity related healthcare. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic's effects on people's lives and society induced a need for rapid individual and collective sensemaking, including communication forums enabling stakeholders in the health ecosystem to share information, solve problems, and learn. This study specifically focused on the needs of the patients and family caregivers living with cystic fibrosis (CF) or primary ciliary dyskinesia (PCD), conditions that lead to chronic infections and inflammation in the airways. We explored how CF and PCD patients, family caregivers, and clinicians collectively received, processed, and used information about COVID-19 to facilitate self-care and health care decisions at the beginning of the pandemic. We applied macrocognitive theory to analyze qualitatively the questions and answers exchanged in a series of six webinars facilitated by a CF learning network at the beginning of the pandemic (March – April 2020). We identified three macrocognitive functions: sensemaking, decision-making, and replanning. We further generated nine themes: (a) understanding the nature of COVID-19, (b) exploring self-care needs and possibilities, (c) understanding health care possibilities, (d) making decisions about prevention and testing, (e) managing COVID-19 within families, (f) adjusting planned care, (g) replanning chronic care management, (h) defining COVID-19 health care strategies, and (i) refining health care policies. The exchange of questions and answers played a central role in facilitating important cognitive processes, which enabled a rapid anticipation of needs and adaptation of services to support patients, family caregivers, and clinicians during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Eliciting information from patients is fundamental to medical professionals' capacity to deliver good healthcare outcomes in Emergency Departments (EDs). There are different kinds of utterances that "do questioning", and health professionals can variously attend to the medical agenda and the interpersonal aspects of their interactions with those attending the ED in the way that they construct these utterances. We investigate a corpus of ED interactions to determine the prevalence and range of utterances produced by doctors and directed at patients that "do questioning." We developed a questioning utterance typology, informed by previous research on the formulation of such utterances and extended according to observations of our data. We subsequently manually coded 4,355 questioning utterances and report the variety of forms that such utterances can take, considering how these are distributed across doctors at different levels of seniority. We found that doctors at different seniority levels favored similar questioning utterance types and the most frequently used appeared to restrict the contributions of patients. We conclude that our extended typology of questioning utterances has value for understanding the ways in which doctors may encourage patients to provide more extensive responses. [ABSTRACT FROM AUTHOR]

How do consumers perceive risks associated with food contamination? How do they respond to foodborne illness outbreaks and food recalls resulting from food contamination? We report findings from an experiment (N = 1,010) in which participants were exposed to a simulated news report on a food contamination incident that had led to a foodborne illness outbreak and voluntary food recalls. Two characteristics of the food contamination incident were experimentally manipulated – severity (i.e., how serious the consequences of the incident were) and intentionality (i.e., whether the incident was caused by an accident or an intentional act to harm). We found that higher severity generally led to higher risk perceptions and risk-reduction intentions. A contamination incident attributed to an intentional act to harm, as opposed to an accident, caused greater intentions to temporarily reduce consumption of the contaminated food and to seek out more information, but only when incident severity was relatively low. Implications of these findings for effectively communicating food contamination risks are discussed. [ABSTRACT FROM AUTHOR]

Integrating concepts from the communication theory of resilience (CTR) with theories of health information management and media-stimulated interpersonal conversation, this study investigates associations between worry about COVID-19, acquiring health information from government, news, and personal sources, and enactment of resilience processes. Findings from a representative sample (N = 600) of Floridians show that the extent to which people worried that they or their loves ones might contract COVID-19 during the first wave of the pandemic predicted the extent to which they reported getting health information from a range of news (e.g. national and local newspapers) and personal (e.g. family, friends/coworkers) sources. A serial multiple mediator model found that worry about COVID-19 was associated with acquiring information about COVID from news sources, which predicted getting information about COVID from personal sources, which in turn predicted enactment of resilience processes. Discussion centers on the role that emotions as well as information management at multiple levels (e.g. media, close relationships) play in people's attempts to enact resilience in the context of a public health emergency. [ABSTRACT FROM AUTHOR]

The concept of racial, ethnic, or cultural concordance between a healthcare provider and a patient has emerged as a dimension of the patient–physician relationship that could influence health outcomes for minoritized patients, particularly through differences in the way physicians communicate with patients of various races and ethnicities. However, two decades of study on concordance and physician–patient communication have produced contradictory results. Although existing systematic reviews have addressed race, ethnicity, and culture as influences on medical encounters, only one review, published in 2006, has examined the effects of this concordance across multiple ethnicities, specifically focusing on physician–patient communication. Given the heightened societal awareness of racism and health disparities in recent years, there is a need for a comprehensive review of the current state of knowledge. This review, therefore, will seek to determine how communication patterns differ in ethnically, racially, and culturally concordant versus discordant patient-provider medical encounters, in the process identifying explanatory and outcome variables associated with those differences. [ABSTRACT FROM AUTHOR]

Two experiments examined if persuasive effectiveness of health messages varies as a function of the communication channel (Facebook vs. news website), and if so, why. Specifically, we examined perceived ulterior motives of the communicator as an explanation for why public health campaigns may be less effective when conveyed via mass-directed (vs. interpersonal) channels, and further investigated if message recipients' health interest moderates such channel effects, if any. In Study 1 (N = 103), reading a medical news reporter's Facebook post on dental health (vs. a news article consisting of the identical content) lowered the participants' suspicion of ulterior motives of the source, which then promoted message-consistent attitudes and behavioral intention. Such effects, however, emerged only for those more interested in health. Using a different topic (a low-carb, high-fat diet), Study 2 (N = 338) replicated Study 1 findings, confirming the conditional persuasive advantages of social media over mass media as a health campaign channel. [ABSTRACT FROM AUTHOR]

Despite its prevalence, research on health information sharing via social network sites (SNSs) is mostly descriptive and often lacks a coherent theoretical framework. By integrating social support and socioemotional selectivity theory, the present study takes a uses and gratifications approach to examining what factors affected health information sharing via WeChat, the most widely used SNS in China. Results of an online survey (N = 519) show that emotional and informational support provisions both predicted health information sharing via WeChat. In addition, age moderated the effects of both support provision. While the relationship between emotional support provision and health information sharing was stronger among older adults, the effect of informational support provision was marginally significantly stronger among younger adults. These findings provide additional understanding of health information sharing via SNSs by revealing its emotional meaning and demonstrating different sharing motivations in different age groups, which offers implications on health information design, dissemination, and discussions in different groups. [ABSTRACT FROM AUTHOR]

Social media is a primary source of sexual health information for young adults. Increased exposure to sexual health education on social media is associated with safer sexual behavior. Given the diversity of social media accounts, condom brands may be a trusted source of sexual health information. We quantified user interactions on the social media posts of the three most frequently used social media sites of condom brands from January 2020 to June 2021. We analyzed the reach each account had in terms of sexual health information separated into three categories: sexual health education, sexual health resources and social issues relating to sexual health. On Instagram, 48% of posts provide sexual health education, 5% mention resources, and 23% mention social issues. On YouTube 68% of posts provide sexual health education, 35% mention resources, and 31% mention social issues. Providing sexual health education had a positive association with likes on Instagram (n = 923, t = 4.09, p <.001). In terms of sexual health education topics, posts pertaining to reproductive health and sexual self-acceptance were a positive predictor of likes on Instagram (n = 56, t = 7.00, p <.001, n = 77, t = 2.37, p =.015 respectively). Posts pertaining to sex were a positive predictor of likes both on Instagram (n = 74, t = 2.79, p =.005) and YouTube (n = 57, t = 2.21, p =.029). These findings suggest that the sexual health education and resources provided by condom brands have significant reach and positive reception. To promote sexual health to a larger and more receptive audience, future research and education campaigns should recognize and utilize the social media influence of condom brands. [ABSTRACT FROM AUTHOR]

Advanced Web 2.0 communication technologies have facilitated health-related information (HRI) sharing on the Internet. Especially, the COVID-19 pandemic and lockdowns around the world have forced more people to turn to the Internet for HRI. A better understanding of users' sharing content and sharing behavior can help communicators improve health literacy, raise community awareness, and facilitate social support exchanges. This paper reports the results of a systematic review of online HRI sharing literature, including key research topics, theories and methods used in past studies, and key factors of sharing behavior across online platforms. Following the PRISMA procedure for a systematic review, 58 articles were identified and analyzed using keyword matching, thematic analysis, and expert review. Guided by the platform theory, our findings differentiated five types of online platforms that differently influenced online users' sharing content and sharing purposes, including micro-blogs, social network sites, online health communities, social question and answer sites, and Wikis. The findings also clarify five main research topics and applicable theories used in each topic, including personal health sharing, health-related knowledge sharing, general health message diffusion, outcomes of HRI sharing, and exploratory research. Key factors of sharing behavior and potential sharing outcomes are also reviewed and summarized in the research framework developed from the motivation theory. Our study contributes to the understanding of online sharing behavior and provides implications for health communicators to develop effective health campaigns. Potential research directions are also identified and discussed. [ABSTRACT FROM AUTHOR]

Managing the information needs of diverse populations through accessible, high-quality, and evidence-based health communication is critical to controlling the COVID-19 pandemic. Access to comprehensive information is especially important for the >25 million limited English proficient (LEP) individuals in the U.S. who prefer to communicate in languages other than English. We assessed the alignment of COVID-19 communication with LEP constituents' needs by examining multilingual content availability on the health department websites of the largest U.S. cities by population. To guide content analysis, we designed a codebook to evaluate six content types, six delivery modes, and three score measures for each website; for each, we measured Holsti's percent of agreement. We then compared the amount of information provided in all combined content types across cities and languages by delivery mode. We thematically analyzed open-ended responses about users' experiences with each city's webpages. We found that COVID-19 information was not presented consistently across languages: many cities provided less information among several delivery modes in other languages compared to English. We found a discrepancy in the amount of information, presentation quality, and ease of navigability of the information among languages and between cities. Users described having negative experiences with most cities' COVID-19 websites in languages other than English. Our findings indicate a gap in the application of the cultural sensitivity approach by local health departments to address issues related to equitable multilingual, multimodal emergency communication, and underscore the need to improve guidelines for communicating public health information as a component of advancing health equity. [ABSTRACT FROM AUTHOR]

During times of a pandemic, government emergency response webpages are an important communication channel and if properly managed, will mitigate pandemic impacts. Guided by the Crisis and Emergency Risk Communication (CERC) framework and web interactivity literature, this study examined the information content and interactivity of U.S. state governments' COVID-19 homepages when many states declared stay-at-home orders in March or April of 2020. Using a web archive service, we retrieved 48 state governments' COVID-19 homepages. Three coders coded these pages for the presence or absence of information content on five dimensions (timely updates, sensemaking information, efficacy information, targeted guidance, and anti-stigma communication) and interactivity on four dimensions (accessibility, navigability, media richness, and engagement). Results revealed that a large proportion of state governments' COVID-19 homepages provided timely information facilitating people's understanding of the pandemic. Yet, there were some information gaps regarding how to cope with the pandemic or its related problems, such as mental stress and social discrimination. While many COVID-19 homepages allowed easy navigation, page engagement and accessibility seemed inadequate. U.S. state governments' COVID-19 homepages could be a good source for sensemaking. Practitioners and researchers should explore how to better harness interactive Internet technologies and present information that fosters people's efficacy to manage through the pandemic. [ABSTRACT FROM AUTHOR]

Undetectable = Untransmittable (U = U) is the scientific fact that HIV cannot be transmitted when an individual is virally suppressed. This breakthrough discovery has the potential to greatly reduce HIV stigma and its negative effects. However, U = U is not widely known. Given that Twitter has the potential to raise awareness of health issues, the purpose of this study was to analyze the content of the #UequalsU on Twitter. The results showed that mentioning sex and mentioning love were strong predictors that a tweet would be liked and retweeted. This information could help to spread the message of U = U more widely and potentially lessen HIV stigma. [ABSTRACT FROM AUTHOR]

An experimental study exposed participants (N = 299) to different message frames to investigate whether Family Communication Patterns (FCP) and message characteristics influenced willingness to communicate about Family Health History (FHH). Message frames were either collective (our), individual (mine), or control (no pronouns). Afterward, participants were asked about their perceived collective psychological ownership of health information, attitudes, subjective norms, and FHH communication intentions. Although the message frames had no impact on perceived collective psychological ownership of health information, conversation orientation and conformity orientation (respecting parental authority) were positively associated with perceived collective psychological ownership of health information. Additionally, perceived collective psychological ownership, attitudes, and subjective norms were found to have indirect effects between FCP and FHH communication intentions. These findings provide further support that FCP influences how health message appeals are processed and suggest interventions could be tailored to FCP orientations for effective FHH behaviors. [ABSTRACT FROM AUTHOR]

Online communities are increasingly important discursive spaces in which individuals obtain health information and engage in sensemaking, and they play an especially essential role during viral outbreaks in which social distancing requirements may preclude engagement with other communities and information sources. However, the manner in which those communities evolve in response to a rapidly developing public health crisis, as well as in reaction to one another, is not well-understood. This longitudinal study uses latent Dirichlet allocation to assess the co-evolution of three subreddits focused on COVID-19 during the earliest, most volatile stages of the outbreak. The results demonstrate the power of being the first online community addressing an emerging health crisis as well as the manner in which latecomers to the conversation gravitate toward distinct niches to differentiate themselves with respect to both topical foci and associated communication styles. The results also highlight individuals' detachment toward developments in even an unprecedented crisis such as a global pandemic, which represents a critical barrier that health communication professionals must overcome to persuade audiences to take health crises seriously. Future studies should examine the potential role of coordination among community administrators as well as the extent to which users are aware of and exert agency over the co-evolutionary processes spanning multiple communities. [ABSTRACT FROM AUTHOR]

Drawing on a multiplicity of mass media and health behavior theories, we propose an integrated health communication (IHC) framework to understand and leverage the ways in which mass mediated and interpersonal sources of health information influence the public's health behavior in the context of their prescription drug decisions. Building on the agenda setting theory, two-step flow theory, and the Health Belief Model, we dig into the interrelationships between mass media and interpersonal information sources and information seeking engagement. Employing survey methodology, our framework was tested using a sample of U.S. adults (N = 628). The major results include (a) information gained through interpersonal sources and perceived benefits of the prescription drugs positively and sequentially mediate the association between mass media exposure and intent to seek prescription drug information, (b) interpersonal health information positively moderate the mediation of mass media exposure – perceived benefits – intent to seek prescription drug information, and (c) the inexpert interpersonal information's positive interaction effect with mass media exposure on intent to seek prescription drug information mediated through perceived benefits was greater with high expert interpersonal communication. These results impart valuable theoretical contributions and have the potential to guide integrated health communication (IHC) campaigns. [ABSTRACT FROM AUTHOR]

The human papillomavirus (HPV) vaccine is relatively novel to people in China. Social media is becoming an important channel for learning new health information. However, limited is known about what HPV vaccine information has been disseminated on social media, and how such online information is associated with health-related behaviors in China. Based on Longo et al.'s model of patient use of healthcare information for healthcare decision, and Longo's model of health information seeking behaviors, this study examined HPV vaccine-related information type and information acquisition pattern. Following the mixed-methods approach, we first crawled 67,773 postings about HPV vaccine on Weibo, the largest microblogging website in China, and performed topic modeling to identify HPV vaccine-related topics that are prevalent on Weibo. The results showed six major topics about HPV vaccine, namely policy, guidance information, advertising, scandals, personal experience sharing, and HPV risks. Second, we conducted an online survey (n = 1,982) to investigate how scanning, seeking, and discussing the six HPV vaccine topics identified from big data analytics can affect HPV vaccine knowledge, safety concern, and vaccination intention. We documented significant impacts of social media health communication on users' health knowledge, attitude and behavioral intention. [ABSTRACT FROM AUTHOR]

In this study, we extended and tested the privacy calculus framework in the context of a hypothetical AI-based contact-tracing technology for application during the COVID-19 pandemic that is based on the communication privacy management and contextual integrity theories. Specifically, we investigated how the perceived privacy risks and benefits of information disclosure affect the public's willingness to opt in and adopt contact-tracing technologies and how social and contextual factors influence their decision-making process. Four hundred eighteen adults in the United States participated in the study via Amazon Mechanical Turk in August 2020. A percentile bootstrap method with 5,000 resamples and bias-corrected 95% confidence intervals in structural equation modeling was used for data analysis. The participants' privacy concerns and perceived benefits significantly influenced their opt-in and adoption intentions, which suggests that the privacy calculus framework applies to the context of COVID-19 contact-tracing technologies. Perceived social, personal, and reciprocal benefits were identified as crucial mediators that link contextual variables to both opt-in and adoption intentions. Although this study was based on a hypothetical AI-based contact-tracing app, our findings provide meaningful theoretical and practical implications for future research investigating the public's technology adoption in contexts where tradeoffs between privacy risks and public health coexist. [ABSTRACT FROM AUTHOR]

In recent decades, women's use of contraception has evolved. Women not only utilize contraceptives to prevent pregnancy, but also to manage menstruation and other factors related to their personal agency. Despite an abundance of available contraceptive options, many women struggle to navigate and address their contraceptive needs. A hundred and thirty-four female participants responded to an open-ended questionnaire about contraceptive messages and decision making in an online survey. Using Uncertainty Management Theory as a framework, we illustrate how the women make sense of and manage uncertainty from multiple contraceptive messages. Results highlighted the absence of desired information, and identified messages that women wish they had received from healthcare providers and others. Our findings suggest that women's understanding of contraceptives' side effects is a communicative process in which anecdotal evidence is often treated as medical fact and healthcare providers are viewed as ineffective and dismissive in relaying and addressing information about contraception. In the absence of satisfying healthcare interactions, women seek information elsewhere to make their contraceptive choices. [ABSTRACT FROM AUTHOR]

The current study was designed to examine effective message strategies that can be employed in designing mediated communication messages to improve clinical trial research participation. In the study, a total of 300 participants completed an online experiment in which they responded to five different clinical trial recruitment advertisements whose information sources varied in their credentials and race. Overall, peer-featured ads in which previous clinical trial participants communicated their prior experience in clinical trial participation, compared to expert-featured ads in which medical doctors communicated information about clinical trials, led to higher message and topic relevance, higher message credibility, more favorable attitudes toward clinical trials, and higher intentions to participate in future clinical trials. Further, there was a statistically significant interaction among source credentials, racial match (between source and participant), and participant's race on message and topic relevance such that both White and Black participants rated ads from racially mismatched peers highly effective (greater message and topic relevance); however, for doctor featured ads, White participants reported higher message and topic relevance for racially matched (White doctor) ads, and Black participants reported higher message and topic relevance for racially mismatched (White doctor) ads. We discuss theoretical and practical implications. [ABSTRACT FROM AUTHOR]

Communication about menstrual health continues to be influenced by institutional and social practices which deem it to be unclean and impure. In a country such as India, several customs and traditions reinforce secrecy and shame about menstruation. As such, scholars advocate the need to generate knowledge that can open opportunities to converse on the topic of menstruation and understand issues related to bodily changes. Using a culture-centered approach, this study examined how college-going adult women from two cities in Northern India made sense of menstrual health. Data collection included 20 focus groups with 180 college-going women and interviews with 16 female family members. Participants discussed communication patterns surrounding menstrual health and how they uphold, challenge, and change social practices. Specifically, participants reflected on how they were communicated to about their menstrual health with underpinnings of secrecy and shame and how the influence of current opportunities for openness encourage them to anticipate positive change. Theoretical and practical implications for studying communication around menstruation in diverse cultural contexts are discussed. [ABSTRACT FROM AUTHOR]

The present study tests and extends the RISP model (a) by applying the model in the context of COVID-19 in South Korea and (b) by examining the impacts of information seeking and processing on misinformation exposure and acceptance. Based on a survey of 346 Korean adults, this study showed that information avoidance, but not information seeking, was a positive predictor of misinformation exposure. In addition, heuristic processing, but not systematic processing, moderated the relationship between misinformation exposure and misinformation acceptance, such that the relationship between misinformation exposure and misinformation acceptance was stronger among those who showed greater tendency for heuristic processing. In addition, information insufficiency was a negative predictor of both information avoidance and heuristic processing. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

The 2019 novel coronavirus (COVID-19) has posed substantial threats to global public health. Individuals are extensively exposed to interpersonal sources of health information (e.g., family, friends, colleagues, physicians, and pharmacists). Interpersonal connections often encourage people to question or reinforce other sources of health information, which can affect their perceptions and behaviors. This study integrates research on how exposure to interpersonal health communication affects people's risk perception and affective responses to influence health-protective behaviors such as health information seeking and adherence to protective measures. Findings from an online survey of U.S. adults (n = 488) demonstrated that risk perception and affective responses serve as behavioral motivation factors. The influences of cognitive and affective responses were greater to the extent that individuals believed the health-protective behaviors are beneficial. Our study illuminates how people engage in preventive health behaviors to protect themselves in the COVID-19 context and demonstrates the influence of interpersonal social networks in motivating such behaviors. The theoretical and practical implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

The Zika Contraception Access Network (Z-CAN) was established during the 2016–2017 Zika virus outbreak in Puerto Rico as a short-term emergency response program providing client-centered contraceptive counseling and same-day access to the full range of reversible contraceptive methods at no cost to women wishing to delay pregnancy. An evidence-based communication campaign, Ante La Duda, Pregunta (ALDP), was launched to encourage utilization of Z-CAN services. We assessed the effectiveness of campaign tactics in increasing awareness of Z-CAN among women in Puerto Rico. Data on campaign exposure and awareness were obtained through a self-administered online survey approximately two weeks after an initial Z-CAN visit, while the number of searches for participating clinics were obtained from monitoring the campaign website. Findings demonstrated that the most common ways survey respondents learned about Z-CAN were through friends or family (38.3%), social media (23.9%), a clinical encounter (12.7%), and website (11.7%). Nearly two-thirds (61.1%) of respondents had heard of the ALDP campaign. Over the campaign's duration, there were 27,273 searches for Z-CAN clinics. Findings suggest that evidence-based communication campaigns may increase awareness of needed public health services during emergencies. Word of mouth, social media, and digital engagement may be appropriate communication tactics for emergency response mobilization. [ABSTRACT FROM AUTHOR]

Two-thirds of US adults report hearing news stories about diet and health relationships daily or a few times a week. These stories have often been labeled as conflicting. While public opinion suggests conflicting nutrition messages are widespread, there has been limited empirical research to support this belief. This study examined the prevalence of conflicting information in online New York Times' news articles discussing published nutrition research between 1996–2016. It also examined the contextual differences that existed between conflicting studies. The final sample included 375 news articles discussing 416 diet and health relationships (228 distinct relationships). The most popular dietary items discussed were alcoholic beverages (n = 51), vitamin D (n = 26), and B vitamins (n = 23). Over the 20-year study period, 12.7% of the 228 diet and health relationships had conflicting reports. Just under three-fourths of the conflicting reports involved changes in study design, 79% involved changes in study population, and 31% involved changes in industry funding. Conflicting nutrition messages can have negative cognitive and behavioral consequences for individuals. To help effectively address conflicting nutrition news coverage, a multi-pronged approach involving journalists, researchers, and news audiences is needed. [ABSTRACT FROM AUTHOR]

This study aims to extend the infodemiology framework by postulating that effective use of digital data sources for cancer communication should consider four components: (a) content: key topics that people are concerned with, (b) congruence: how interest in cancer topics differ between public posts (i.e., tweets) and private web searches, (c) context: the influence of the information environment, and (d) information conduits. We compared tweets (n = 36, 968) and Google web searches on breast, lung, and prostate cancer between the National Cancer Prevention Month and a non-cancer awareness month in 2018. There are three key findings. First, reliance on public tweets alone may result in lost opportunities to identify potential cancer misinformation detected from private web searches. Second, lung cancer tweets were most sensitive to external information environment – tweets became substantially pessimistic after the end of cancer awareness month. Finally, the cancer communication landscape was largely democratized, with no prominent conduits dominating conversations on Twitter. [ABSTRACT FROM AUTHOR]

In the early stage of a novel public health crisis, such as an infectious disease, there is often uncertainty about whether the crisis will be permanent. We find that emphasizing the potential permanency of the situation surrounding the crisis can backfire, depending on the implicit self-theory held by people. Data collected during the COVID-19 outbreak showed that when the crisis situation was communicated as potentially being permanent in nature, entity theorists, who view personal qualities as fixed, were more reluctant to adjust to it than incremental theorists, who view personal qualities as malleable. The results were consistent whether implicit self-theory was measured as an individual difference factor (study 1) or manipulated (study 2). We reason that entity and incremental theorists make different inferences about what is required to adjust under the potentially permanent crisis situation: Entity theorists tend to infer that it involves substantial change in the self, whereas incremental theorists tend to infer that it involves crisis-specific behavioral changes. Importantly, we find that communicating ambiguity by leaving open the possibility of two opposing outcomes – the crisis situation may be permanent or temporary – effectively increases entity theorists' intentions to adjust by encouraging them to infer that adjusting to the crisis involves crisis-specific behavioral changes (study 2). [ABSTRACT FROM AUTHOR]

In recent years, doctor-patient communication in the context of traditional Chinese medicine (TCM) has attracted increasing attention. Highly influenced by ancient Chinese philosophy, TCM is unique in its exemplification of Chinese wisdom, particularly with respect to how the idea of zhěngtǐguān (整体观) (lit. whole body concept), realized as "the idea of the whole" or simply "holism," is valued and realized in TCM consultations. Adopting an interactional analytical approach, our study aims to illustrate how TCM doctors and patients co-construct a medical consultation that can exemplify the idea of holism. Based on a spoken corpus of Mandarin Chinese totaling 443 minutes in length, this paper identifies instances of what can be labeled as the voice of TCM (VOTCM) in a typical TCM consultation that reflect the idea of holism and describes and analyzes the communicative routines that are specific to these TCM consultations. It is observed that the steps and strategies involved in the consultation not only illustrate the collaborative co-construction of holism but also point to the holistic aspect of TCM philosophy, particularly topics related to the different body parts and the lifeworld. The diagnostic explanations provided by doctors and the co-topical talks between doctors and patients at various stages of the consultation also play an important role in the co-construction and realization of holism. [ABSTRACT FROM AUTHOR]

Public health crises like the ongoing COVID-19 pandemic appear to be the perfect breeding ground for misinformation. As influential information sources, mainstream news media have a unique opportunity to use their platform to debunk and educate the public about misinformation. Despite evidence lending support to the potential for mainstream news media to play a larger role in combating misinformation in society, empirical explorations of how they have contributed to the management of misinformation remain scant. This study aims to address these major gaps in research by investigating how mainstream news dailies gatekeep and correct COVID-19 related misinformation in Singapore. The content of 164 news articles published by the mainstream news dailies in Singapore from January 1 to April 30, 2020 on COVID-19 misinformation was analyzed qualitatively and quantitatively. Results show that the two main types of misinformation, fabricated and reconfigured misinformation, were covered almost equally by mainstream news media. Misinformation related to science and health were most frequently reported, followed by scams, and government policy. Statistically significant differences were found between how mainstream news media corrected the various types and topics of misinformation. Significant differences were also found within the various types, topics, and corrections of misinformation across the early stages of the pandemic. Taken together, these findings shed light on the critical role of mainstream news media as public education tools to correct misinformation during public health crises. From a theoretical perspective, these findings contribute to the understanding of media misinformation gatekeeping, and misinformation correction. From a practical perspective, it highlights the capacity and potential roles of the press in supporting government efforts to combat misinformation. [ABSTRACT FROM AUTHOR]

The goal of this study was to investigate the effects of sources of information on COVID-19 risk perceptions. Using data from a representative sample of the Portuguese population (N = 1,411) collected early in the pandemic, we find that while media sources were more frequently used, scientific sources played a more important role on perceived personal and societal-level risks; higher trust in scientific sources associated with increased risk perceptions (i.e., amplified perceived risk), trust in social media associated with dismissing personal threat (i.e., attenuated perceived risk). These findings suggest that people's relations with science were determinant factors in risk perceptions, and dimensions that measure these deserve further investigation. [ABSTRACT FROM AUTHOR]

A pandemic is a unique form of health crisis that requires intensive communicative efforts. In order to achieve positive health outcomes, messages need to be carefully designed. In this context, both message specifics and audience specifics receive consideration. This research tries to scrutinize (1) which message appeal (emotional vs. informative) is perceived more favorable by the Austrian public, (2) which message appeal (emotional vs. informative) leads to a higher degree of message empowerment, and (3) the degree to which message empowerment can be enhanced by (a) message specifics and (b) a combination of message and audience specifics. A quantitative survey with 337 Austrians revealed that the emotional appeal message led to a higher degree of message empowerment than the informative appeal message. Moreover, only message specifics were found to enhance message empowerment. Implications for message design are derived, before limitations and directions for future research are addressed. [ABSTRACT FROM AUTHOR]

School-based health interventions are potentially an effective method to communicate health messages to adolescents. Unfortunately, effectiveness of such interventions is limited. Research in other contexts has shown that interpersonal communication can influence the effectiveness of health programs, but this has not been thoroughly tested for school-based health interventions. Therefore, our study investigated interpersonal communication (i.e., conversational valence and frequency) in a school-based intervention context. We used a three-wave randomized-controlled trial with 1056 students to study three aims. The first aim was to investigate the influence of a health intervention on conversational frequency and valence about drinking, snacking, and exercising. Our second aim was to investigate the influence of conversational frequency and valence on (predictors of) drinking, snacking, and exercising. Our third aim was to investigate whether the health intervention indirectly influenced the program outcomes through conversational frequency and valence. Findings showed that conversational frequency and valence were related to (predictors of) the three behaviors. Additionally, findings showed that the intervention did not influence conversational frequency and valence. Accordingly, findings showed no indirect influence of the intervention on program outcomes through conversational frequency and valence. Our findings show the potential of interpersonal communication for health behaviors and predictors; however, they also stress the importance of a health intervention to properly influence interpersonal communication. If health interventions can successfully influence interpersonal communication, intervention effectiveness can be improved. [ABSTRACT FROM AUTHOR]

Cancer is one of the most common causes of death in China and the United States. Past studies found that cancer risk perceptions, fatalistic beliefs, and worry were prominent predictors of health-related behaviors. Perceived cancer risks, fatalistic beliefs, and worry were associated with cancer information acquisition in the United States. However, little is known about whether these factors played comparable roles in China. This study investigates the psychological antecedents of cancer information acquisition using data from Health Information National Trends Surveys (HINTS) in both countries. Results showed that cancer worry was negatively related to cancer information avoidance in the U.S. but positively related to information avoidance in China. Also, whereas cancer fatalistic beliefs were negatively associated with cancer information seeking in the U.S., the relationships between fatalistic beliefs and cancer information seeking exhibited more complex patterns in China. Implications for cancer communication in different cultures are discussed. [ABSTRACT FROM AUTHOR]

Obesity and diabetes are widespread health conditions with rising prevalence rates in the United States. News stories and health campaign messages frequently feature prevalence rates of obesity and diabetes, at times under the expectation that such messages will increase readers' disease awareness, health behaviors, and policy support. At the same time, American adults overestimate the prevalence of obesity and diabetes in the absence of prevalence information, raising important questions about the implications of communicating accurate prevalence information that may be lower than baseline estimates. The current study examines the effects of communicating information about the prevalence of obesity and diabetes, varying the format of this information (using qualitative terms, raw frequencies, or percentages). Results from two pre-registered, web-based randomized experiments suggest that only prevalence statistics in percentage formats shift readers' prevalence estimates, though in some percentage formats these estimates were lower than observed in a no-message control group. Prevalence estimates, in turn, were positively associated with perceived social causes of obesity/diabetes, intensions for healthy behaviors, and support for policy-level solutions. These findings offer guidance for health communication campaigns that seek to increase healthy behavior and support for policies to address health conditions. [ABSTRACT FROM AUTHOR]

In times of public health emergencies, health agencies need to engage and communicate with the public in real-time to share updates and accurate information. This is especially the case for the COVID-19 pandemic where public engagement can potentially save lives and flatten the curve. This paper considers how the use of interactive features and strategic network positions of health agencies on social media influenced their public engagement outcomes. Specifically, we analyzed 203 U.S. public health agencies' Twitter activity and the public engagement they received by extracting data from a large-scale Twitter dataset collected from January 21st to May 31st, 2020. Results show that health agencies' network position in addition to their two-way communication strategy greatly influenced the level of public engagement with their COVID-19 related content on Twitter. Findings highlight the benefits of strategic social media communication of public health agencies resides not only in how agencies use social media but also in their formation of network position to amplify their visibility. As official sources of health and risk information, public health agencies should coordinate their social media communication efforts to strategically position themselves in advantageous network positions to augment public engagement outcomes. [ABSTRACT FROM AUTHOR]

Although there has been a consensus that health organizations should better utilize dialogic capabilities of online platforms, little is known about if the effectiveness of dialogic communication varies across message platforms, and if so, why. An experiment (N = 209) examined how message platforms (i.e., website vs. Twitter) moderate the effect of dialogic messages and uncovered a novel theoretical mechanism underlying such effect. Exposure to dialogic (vs. monologic) messages about a health risk yielded greater sense of direct conversation with the health organization (i.e., social presence). However, such effect was observed only when the messages were delivered via the organization's website. In the organization's Twitter, dialogic and monologic messages did not exert significantly differential influence. Enhanced social presence, in turn, reduced psychological distance to the risk, which subsequently induced stronger risk-preventive behavioral intentions. [ABSTRACT FROM AUTHOR]

Black Americans make up 13% of the U.S. population, yet account for 54% of HIV deaths and 44% of new HIV diagnoses. Why do Black Americans die from HIV at such a disproportionate rate? In the current study, we asked whether the presence and behavior of in-group peers in public health settings may influence Black Americans' attention to HIV information, given the racialized nature of HIV-stigma in Black American communities. In a quasi-experimental field study conducted in a public health clinic (N = 260), we found that Black patients were less likely to pay attention to HIV-prevention information in the presence of other Black patients, unless those patients were also paying attention to the information. In contrast, Black patients' attention was unaffected by the presence of White patients. We end by discussing the implications of these findings for health communication theories and health practice geared toward reducing racial-health disparities in the United States. [ABSTRACT FROM AUTHOR]