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An observational cross-sectional study was conducted among inhabitants of Costa Rica to examine motivational determinants of COVID-19 vaccination intentions (CVI), as well as to better understand the role of a set of conspiracy-related variables within the framework of the Theory of Planned Behavior (TPB). Data were collected online, and a subsample of those not yet vaccinated (N = 406, age = 44.35, S. D. = 13.23, 74.9% women) was selected. They reported TPB-variables, risk perception, conspiracy-related variables, and sociodemographic information. Structural equation was used to model the assumption that conspiracy beliefs presented direct and indirect effects on intentions. Conspiracy thinking, denialism, and sociodemographic information were also specified as determinants of conspiracy beliefs and vaccination intentions. Most determinants presented direct effects on intentions. Only perceived behavioral control, denialism, and conspiracy thinking presented no direct effects on intentions. Conspiracy beliefs had indirect effects on intentions via most TPB-variables and risk perception. Conspiracy beliefs were predicted only by conspiracy thinking, gender (male), and education. Sociodemographic variables had no effects on intentions. Evidence suggested that a mechanism integrating conspiracy-related variables, risk perception, and TPB-variables predicted CVI. Education and gender played a role in the onset of conspiracy beliefs and thereafter vaccination intentions. [ABSTRACT FROM AUTHOR]

This study aims to unravel the key determinants of individuals' information seeking behavior during health crises. It challenges conventional perspectives that solely emphasize individual experiences. It also undermines frameworks that draw direct parallels between individual experiences and media factors, disregarding the mediating role of media. Models like the Comprehensive Model of Information Seeking (CMIS) also have limitations as they prioritize media mediation over recognizing the direct impacts of individual experiences on information seeking behaviors. We hereby propose a framework, the Media-Mediated Model of Information Seeking Behavior, that sheds light on the interplay between individual and media experiences. Analysis of survey data involving 5,469 participants in three Chinese societies, including mainland China (n = 2,067), Hong Kong (n = 1,913), and Taiwan (n = 1,489), reveals that individual experiences have both direct and indirect effects on information seeking, mediated by media utility. Experience of symptoms and risk perception depend on people's perceptions of the utility of media, while efficacy and media trust directly influence information seeking behaviors. These findings contribute to theoretical understanding and offer practical guidelines. Public institutions and health promoters can leverage media platforms to shape people's perceptions of health issues and encourage active information behaviors. It is also crucial to prioritize cultivating public trust in media and efficacy during crises. [ABSTRACT FROM AUTHOR]

In the context of climate change communication, this study explores the process through which exposure to media messages about a risk leads to recommended behavioral intentions. We propose a model of this process based on the Extended Parallel Process Model (EPPM) and the Risk Perception Attitude (RPA) framework. Our model analyzes how risk perception, negative emotion, and efficacy beliefs mediate and moderate the effects of media messages on people's intention to engage in pro-environmental behaviors. A national survey among 1,000 adults in South Korea was analyzed, and the fitting of PROCESS Models 4 and 15 yielded four main findings. First, media exposure was directly and positively related to risk perception, negative emotion, and pro-environmental behavioral intention. However, the significant relation between media exposure and behavioral intention was partly conditional upon efficacy beliefs. Second, risk perception and negative emotion were also significantly related to behavioral intention conditional upon efficacy beliefs. Third, efficacy beliefs significantly moderated the relation between risk perception and behavioral intention, but not between negative emotion and behavioral intention. Fourth, efficacy beliefs served as a moderator for the indirect effect of media exposure on behavioral intention via risk perception and negative emotion. [ABSTRACT FROM AUTHOR]

The current study has three main purposes: to examine 1) the impact of theory-driven corrective messages using individual vs. collective frames on information-seeking intention 2) the mediating role of risk perceptions and 3) the moderating role of reflection and gender. Our findings from a randomized experimental study and Hayes' moderated, moderated mediation model show collective frames were associated with high-risk perceptions among women, which in turn led to higher information seeking intention. The second moderator reveals that people who scored higher on reflection were more willing to seek information. Our findings have critical implications for misinformation research by demonstrating the importance of theoretically driven messages in understanding misperceptions as well as people's information seeking behavior. [ABSTRACT FROM AUTHOR]

To reduce the impact of communicable diseases like COVID-19, collective action is required and likely to be susceptible to normative influence as well as whether people are more or less collectively oriented. We extend the theory of normative social behavior (TNSB) to account for group orientation and predict the relationships between social norms and physical distancing behaviors. Using a rolling cross-sectional design during 17 weeks of the pandemic, a national sample of US residents from 20 states (N = 8,778) participated in the study. The findings show that perceived descriptive norms, injunctive norms, and group orientation are significantly associated with physical distancing. The descriptive norm-behavior relationship and injunctive norm-behavior relationship are moderated by group orientation and the other predicted moderators in the TNSB. The findings extend the TNSB and highlight the need to understand social norms and group orientation in formative research for health communication campaigns designed to promote prevention behaviors. [ABSTRACT FROM AUTHOR]

Pictorial warning labels (PWLs) featuring narrative content are promising strategies for communicating health risks and motivating behavior change. The objectives of this study were to (1) identify what intrinsic features a PWL must have to be constructed as a narrative and (2) uncover in what ways narrative PWLs are perceived as being (in)effective. Seven online focus groups were conducted via Zoom with moderate and heavy drinkers (n = 30). Participants discussed a series of mockup PWLs designed to communicate the cancer risk of alcohol. The discussion revealed that a static image must include character, causality, and setting to help individuals construct the story. Specifically, the character should be discernible and believable so that individuals can infer risk information. Moreover, the connection between the image and text should imply a causal relationship between alcohol drinking and cancer risks. Lastly, there should be sufficient relevant background or context information. When discussing the label effectiveness, most participants thought narrative PWLs were more effective than graphic, non-narrative PWLs at informing consumers about the cancer risk of alcohol. Their reasoning included narrative PWLs (1) being easy to understand, (2) evoking curiosity and imagination, (3) eliciting sympathy for the character, (4) not causing aversion, and (5) increasing risk perceptions. This study contributes to the narrative persuasion research and offers practical implications for designing image-based narratives. [ABSTRACT FROM AUTHOR]

Although Valley fever represents a growing public health challenge for Central and Southern Californian residents, awareness remains severely limited. The California Department of Public Health (CDPH) ran a cross-platform campaign to mitigate this awareness gap and impact prevention behavior. This study evaluates exposure to the CDPH campaign, followed by an examination of the information consumption patterns associated with key health outcomes. Results suggest that the CDPH campaign successfully improved knowledge accuracy, reduced misperceptions, and increased the likelihood of prevention behavior. Using an information repertoire lens revealed a more nuanced account. Most information repertoires positively influenced accurate knowledge retention and prevention behavior compared to those who were not exposed. The most diverse information repertoire, including interpersonal and media channels, was associated with increased knowledge accuracy, affective risk concerns, personal susceptibility, and prevention behavior. However, exposure to this repertoire was also associated with greater misperceptions. In addition, medical professional and radio-based repertoires positively influenced personal susceptibility perceptions. Overall, this research illustrates the importance of examining not only the general outcomes of health campaigns but also the patterns of information acquisition – particularly when working with underserved communities whose health information consumption preferences may not be comprehensively reflected in the literature. [ABSTRACT FROM AUTHOR]

Social media use for risk communication during the COVID-19 pandemic has caused considerable concerns about an overabundance of information, particularly misinformation. However, how exposure to COVID-19 information on social media can lead to subsequent misinformation sharing during the pandemic has received little research attention. This study adopted the social amplification of risk framework to delineate how exposure to COVID-19 vaccine information on social media can be associated with individuals' misinformation sharing through heuristic information processing. The role of social media trust was also examined. Results from an online survey (N = 1488) of Chinese Internet users revealed that exposure to COVID-19 vaccine information on social media was associated with misinformation sharing, mediated by both affect heuristics (i.e., negative affect toward the COVID-19 pandemic in general) and availability heuristics (i.e., perceived misinformation availability). Importantly, both high and low levels of trust in social media strengthened the mediating associations. While a low level of trust strengthened the association between exposure to COVID-19 vaccine information on social media and the affect heuristics, a high level of trust strengthened its association with the availability heuristics, both of which were associated with misinformation sharing. Our findings suggest that heuristic information processing is essential in amplifying the spread of misinformation after exposure to risk information on social media. It is also suggested that individuals should maintain a middle level of trust in social media, being open while critical of risk information on social media. [ABSTRACT FROM AUTHOR]

China has a longstanding tradition of alcohol consumption, yet excessive drinking poses significant health risks, particularly for individuals with cardiovascular conditions such as hypertension. While existing literature indicates that both health information scanning and seeking behaviors can impact health beliefs and actions, their effects on alcohol prevention remain understudied. Utilizing data from a national survey in China, this study investigates the influence of health information scanning and seeking on alcohol risk knowledge and the frequency of excessive drinking among hypertensive drinkers. Results demonstrate that both health information scanning (b = -.018, p < .05) and seeking (b = -.030, p < .001) are negatively associated with excessive alcohol consumption indirectly through heightened awareness of alcohol as a risk factor for cancer. However, health information scanning is positively linked to excessive drinking directly (b = .203, p < .01). Additionally, cancer information overload positively moderates the relationship between awareness of alcohol as a cancer risk factor and excessive drinking (b = .148, p < .001). Hypertensive drinkers who experience lower levels of cancer information overload are more inclined to reduce excessive alcohol consumption. These findings underscore the different roles of health information scanning and seeking on alcohol control. It is important to implement interventions aimed at encouraging active information seeking and mitigating information overload. Educational programs should be promoted to help high-risk groups accurately understand the risk of excessive drinking. [ABSTRACT FROM AUTHOR]

Using a stratified sample of German residents (N = 1,508), we examined intentions to avoid information about vaccination against COVID-19. The study was guided by the planned risk information seeking model (PRISM), also taking into consideration benefit perceptions, positive affective responses, and discrete emotions. Our findings generally supported the utility of the extended PRISM to predict information avoidance intentions; most of the hypothesized relationships were supported and the model accounted for 58.8% of the variance in intentions to avoid information about COVID-19 vaccination. Furthermore, perceived benefits of vaccination, and positive affect felt toward vaccination played significant roles in explaining intentions to avoid information about vaccination. A more nuanced view on affective predictors showed that hope and interest were weakly associated with less pronounced avoidance intent, whereas we found no link between avoidance intent and fear, anxiety, and anger. [ABSTRACT FROM AUTHOR]

Public response to the COVID-19 pandemic provides a unique opportunity to study how lay people's risk perception involves their emotive responses. We investigated how outrage factors as emotional responses to risk influence levels of risk perception in the context of the pandemic disease. Furthermore, how media use influences the perception of outrage factors is also examined. A nationwide online survey (n = 1,000) was conducted in South Korea. The survey results indicated that pandemic risk perception was connected to the generic intensity of perceived outrage factors as measured by averaging the perception of multiple outrage factors. Individual outrage factors such as personal stake, effect on children, dread, and controllability directly influenced risk perception regarding COVID-19. When the intensity of media use was considered, individuals with heavy media use perceived outrage factors more intensely than those who used media less frequently. Media use also moderated the outrage effect of catastrophic potential and moral nature on the perception of risk associated with the pandemic disease. For heavy media users, the outrage effect of moral nature was increased, while that of catastrophic potential decreased. The implications of the outrage effect on the pandemic disease risk perception are addressed. Finally, we discuss the meaning of heavy media users' varying levels of vulnerability to outrage effect by moral nature and catastrophic potential. [ABSTRACT FROM AUTHOR]

This study examines the effects of message framing (loss vs. gain) and format (narrative vs. expository) on intentions to discuss flu vaccination with a close social referent. We test the effects of video messages using a two-wave web-based randomized experiment among adults in Israel (baseline: N = 429, one-month follow-up: N = 241). Exposure to narrative messages was positively associated with intentions to discuss flu vaccination. Exposure to loss-framed messages was positively associated with increased likelihood of discussing vaccination with the referent at follow-up. Effects of message framing and format were moderated by concern for the referent's health. Findings support the use of persuasive messages to motivate interpersonal conversation to promote vaccination. Results contribute to theory on risk-framing by showing that audiences may evaluate loss-framed messages according to their risk perceptions, when greater concern for health risks motivate action, not only for one's own health but for another person's health. [ABSTRACT FROM AUTHOR]

Although visual depictions of epidemiological data are not new in public health, the US public saw more of them during the COVID-19 pandemic than ever before. In this study, we considered visualizations of forecasts (i.e. predictions of how a disaster will unfold over time) formatted as line charts. We investigated how two choices scientists make when creating a forecast visual – the outcome of focus (cases or deaths) and the amount of data provided (more or less data) about the past or the potential future – shape behavioral intentions via risk-related appraisals (e.g. threat and efficacy). In an online experiment, participants (N = 236) viewed a written health alert about a novel airborne virus, with one of the eight versions of a forecast visual or no visual (text only). The results of the experiment showed that exposing people to a health alert with a forecast visual in it may be less effective than anticipated. Reading a written health alert with a forecast visual was, at best, equal to outcomes from reading an alert without it, and sometimes it performed worse: participants appraised the novel virus as a less urgent threat and the recommended solutions as less efficacious. Implications of the findings for theories of risk and visual health communication and practical considerations for future health communicators were discussed. [ABSTRACT FROM AUTHOR]

We sought to examine the relationship between perceived message effectiveness (PME) and actual message effectiveness (AME) in a 3-week randomized trial of vaping prevention advertisements. Participants were US adolescents (n = 1,514) recruited in 2021. We randomly assigned them to view The Real Cost vaping prevention ads or control videos online. Participants viewed three videos at Visit 1, again at Visits 2 and 3, and completed a survey at each visit that assessed AME (susceptibility to vaping) and two types of PME – effects perceptions (potential for behavioral impact) and message perceptions (potential for message processing). At Visit 4, AME was measured. Compared to control, The Real Cost ads led to improved AME (lower susceptibility to vaping at Visit 4, p <.001). This was anticipated by The Real Cost ads eliciting higher PME ratings (higher effects and message perceptions at Visit 1, both p <.001). Furthermore, PME (both effects and message perceptions) at Visit 1 predicted susceptibility to vaping at Visits 1, 2, 3, and 4 (all p <.001). Finally, effects perceptions fully mediated the impact of The Real Cost ads on susceptibility to vaping (β = −.30; p <.001), while message perceptions only partially mediated the effect (β = −.04; p =.001). Our findings indicate a relationship between PME and AME, especially effects perceptions, and suggest that PME may be useful in message pre-testing to select messages with greater behavior change potential. [ABSTRACT FROM AUTHOR]

This research examined the relationship between exemplar characteristics and concern for maternal health disparities. A two-wave 2 (familiarity) X 2 (vividness) between-subjects experiment tested the effects of exemplar familiarity and vividness on attitudes toward maternal health and maternal health disparities, perceptions of disparate risk, and policy support after exposure to a story about a mother who faced complications during childbirth and again three to five days later. The moderating role of political ideology was also examined. Results revealed positive effects of vividness on attitudes toward maternal mortality in general, attitudes toward maternal health disparities, and support for policies to address them in the short-term. Effects on general attitudes persisted three to five days later. Contrary to predictions, no effects were found for familiarity at Time 1. A familiar exemplar elicited more negative attitudes toward maternal mortality at Time 2. Examination of the moderating role of politics revealed the impact of vividness on general attitudes and policy support was greater among conservative participants, compared to more liberal participants. In addition to extending the applicability of exemplification theory to perceptions of risk toward others and subsequent policy support, this research has practical applications for bringing public attention to racial health disparities. [ABSTRACT FROM AUTHOR]

Driving under the influence of cannabis (DUIC) is a major cause of preventable death and a growing public health concern. News media coverage of DUIC may influence public perceptions of causal factors for DUIC, risks of DUIC, and potential policy solutions. This study examines Israeli news media coverage of DUIC, and contrasts media coverage according to whether news items refer to cannabis use for medical vs. non-medical purposes. We conducted a quantitative content analysis of news articles related to driving accidents and cannabis use (N = 299) from eleven of the highest circulation newspapers in Israel between 2008 and 2020. We apply attribution theory to analyze media coverage of accidents that were linked to medical cannabis, use compared with non-medical use. News items describing DUIC in the context of non-medical (vs. medical) cannabis use were more likely to: (a) emphasize individual causes (vs. social and political); (b) describe drivers in negative terms (vs. neutral or positive); (c) refer to an increased accident risk due to cannabis use (vs. inconclusive or low risk); and (d) call for increased enforcement rather than education. Results show that Israeli news media coverage of cannabis-impaired driving varied significantly depending on whether it referred to cannabis use for medical purposes, or non-medical purposes. News media coverage may influence public perceptions of the risks of DUIC, the factors that are associated with this issue, and potential policy solutions that may reduce the prevalence of DUIC in Israel. [ABSTRACT FROM AUTHOR]

Guided by narrative transportation theory and the social identity approach, this study examined the effects of character accent on perceived similarity, transportation, and narrative persuasion. Cigarette smokers from Kentucky (N = 492) listened to a first-person narrative about smoking-induced lung cancer. The character spoke either with a Southern American English (SAE; ingroup) or a General American English (GAE; outgroup) accent. Opposite to predictions, the GAE-accented character was perceived as more similar overall, engendered greater transportation, elevated lung cancer risk perceptions, and promoted higher intentions to quit smoking than the SAE-accented character. Consistent with predictions, the effects of character accent on risk perceptions and intentions to quit were mediated by perceived similarity and transportation. Taken together, these findings indicate that narrative character accent is a potent cue to similarity judgments, but that actual linguistic similarity is not isomorphic with perceived overall similarity. Theoretical and practical implications for narrative persuasion are discussed. [ABSTRACT FROM AUTHOR]

This study examines how social media (SM) use is related to human responses to emerging infectious disease risks in the context of the COVID-19 pandemic via an online survey conducted in the United States and Taiwan. Results showed that SM use was related to different types of communicative responses (information seeking, interpersonal discussion, and rumor correction) directly and indirectly through cognitive and affective responses (risk perception, responsibility attribution, and negative and positive emotions). The indirect relationships between SM use and communicative responses through these cognitive and affective responses were moderated by perceived SM network structures. In particular, the mediating influence of negative emotions on communicative responses was associated with perceived SM network homogeneity, while that of positive emotions was related to perceived SM network centrality. Furthermore, responsibility attribution drove Taiwanese SM users' communicative responses, whereas the interrelated influence of positive emotions and perceived SM network centrality shaped American SM users' communicative responses. [ABSTRACT FROM AUTHOR]

Given the absence of COVID-19 treatments, the best way to control the spread of the virus is to break the chain of infection by increasing public participation in preventive behaviors recommended by health authorities. This study proposes a moderated mediation model of information behaviors (e.g. information seeking and information verification) and trust in government that explores the relationship between risk perception and preventive behaviors regarding COVID-19. Using a survey study in South Korea, we conducted the moderated mediation analysis with latent moderated structural equation modeling (LMS). We found serial mediation effects for risk perception, information behaviors, and preventive behaviors, as people both seek out information and verify that information before adopting preventive behaviors. Additionally, trust in government moderated information behaviors in the relationship between risk perception and preventive behaviors, suggesting that trust in government encourages people to adopt more preventive actions via information seeking and information verification. Further implications are discussed to promote public understanding of the health crisis and public participation in preventive measures. [ABSTRACT FROM AUTHOR]

This study, inspired by the Risk Information Seeking and Processing (RISP) model, examines the mechanisms by which perceived hazard characteristics and the informational subjective norms of Chinese youth, aged from 14 to 44 years old, become associated with their intentions to seek cancer risk information online. A sample of 684 Chinese youths was collected from four cities in Mainland China with results revealing that perceived hazard characteristics and informational subjective norms motivate their online cancer risk information seeking intentions. Specifically, perceived probability, perceived severity, and institutional trust are positively related to negative affect, however the relationship between personal control and negative affect is not significant. Institutional trust and personal control are positively related to positive affect while perceived probability and perceived severity have no significant effect on positive affect. Negative affect and informational subjective norms are positively related to perceived information insufficiency, while the relationship between positive affect and perceived information insufficiency is not significant. Negative affect, positive affect, informational subjective norms, and perceived information insufficiency are all positively related to the online cancer risk information seeking intentions of Chinese youth. [ABSTRACT FROM AUTHOR]

As information consumption plays a critical role in addressing vaccine hesitancy in the hybrid media environment, it becomes crucial to understand how individuals' use of a combination of channels and sources affects their vaccine hesitancy. Based on information repertoire approaches emphasizing the multiplicity of channels and sources, we investigated different patterns of information repertoire related to the COVID-19 pandemic and how these patterns affected vaccine hesitancy through different informational mechanisms. Our results based on a U.S. sample suggest that while a richer information repertoire related to increased confidence in vaccines through increased information verification, this richness also corresponded with deepened vaccine hesitancy through heightened cognitive elaboration and perceived information inconsistency. Our findings support the utility of repertoire approaches for better understanding health information acquisition in the complex media ecology. [ABSTRACT FROM AUTHOR]

Knowledge's effect on behavioral responses in a health crisis has been a point of inquiry in many empirical studies that obtained significant findings. However, a variety of knowledge types has been considered in these studies rarely. This study compared the effect of declarative vs. procedural knowledge on behavioral responses to the COVID-19 pandemic. In addition, we examined whether outrage factors, which refer to perceived risk characteristics that are likely to elicit emotional responses, can moderate cognitive knowledge's effect. Data were collected with a survey conducted five months after the first COVID-19 case was confirmed in South Korea. A total of 1,000 respondents completed questions on the two types of knowledge, risk perception, and health behaviors in the pandemic crisis, and three different outrage factors. The results showed that procedural knowledge on how-to-do something was associated significantly with the health behaviors in the crisis, while the declarative knowledge that involves knowing that "something is the case" was not. Further, the outrage factors moderated knowledge's effect in such a way that procedural knowledge's influence on health behaviors diminished when the respondents perceived that the pandemic was uncontrollable. On the other hand, procedural knowledge's effect increased when the outrage factor of fairness was heightened. The implications are discussed in the context of studies of knowledge's effect and the outrage factors' moderation. [ABSTRACT FROM AUTHOR]

With COVID-19's unprecedented impact and ongoing debates on prosocial social distancing and antisocial beach crowd gathering, this study examined the roles of social desirability, social distance marked by race, and social identity in the third-person effect (TPE) of COVID-related news concerning risk perception among Historically Black College and University (HBCU) students. The findings confirmed third- and first-person effects with the perceived influence of antisocial (beach partying) news greater for others than themselves, whereas the self was perceived to be more responsive to the influence of prosocial (social distancing) news. A symmetric interaction between social desirability and social identity indicated that the racial out-group, non-HBCU students in Florida were perceived as more affected by antisocial beach party news, whereas the in-group HBCU peers were perceived as more influenced by desirable social distancing warning news and COVID news in general. The first-person perception and shrunk self-other gap in COVID news influence on HBCU students" concerns may be associated with perceived personal vulnerability and responsibility as well as a political reflection on the government's handling of COVID. While they presumed favorable media influence on self and the in-group to preserve collective self-esteem, they made realistic threat judgments from perceiving undesirable media influence on their in-group peers' risky behavior tendency and intended to take preventive actions (staying home) to avoid the health risk. Further, it was the first-person perceptual gap between themselves and the out-group, non-HBCU students that influenced them to heed social distancing warnings. [ABSTRACT FROM AUTHOR]

Vaccines represent one of the greatest health efforts to help combat diseases, yet they often evoke emotional responses among individuals. These emotional responses can influence an individual's desire to seek information about vaccines. The purpose of this research was to examine these relationships further using the Planned Risk Information Seeking Model (PRISM) and explore the role of emotions, specifically fear and hope, on vaccine-related information seeking intentions. Two separate models were tested using the PRISM model, one for fear and one for hope. Results suggest fear did not have a significant direct effect on vaccine information seeking, while hope had a positive and significant relationship. Interestingly, both attitude toward seeking and perceived current knowledge each had a positive relationship with information seeking intentions in the fear and hope models. Future research should continue to examine the role of specific emotions within the PRISM model to better predict information seeking intentions. [ABSTRACT FROM AUTHOR]

Guided by construal level-theory, this research seeks to understand the effect of perceived psychological distance on emotions and risk perception associated with the COVID-19 pandemic in its early stage. Survey data were collected from a nationally representative U.S. adult sample (N = 1009) in April 2020. Results reveal that social distance was negatively related to emotions and risk perception. However, hypothetical distance was not significantly related to these variables. Emotions and risk perception also mediated the relationship between social distance and support for aid response measures; theoretically, we demonstrate that people evaluate risks contingent on their emotions when making decisions. This research contributes to extant literature on psychological distance and its utility in communication messaging design during public health crises. [ABSTRACT FROM AUTHOR]

When promoting COVID-19 vaccination, the media and public figures often mention hope to return to normalcy and sometimes try to elicit guilt by asking people to get vaccinated to protect themselves and others. Situated within the health belief model, the present research aimed to investigate whether hope and anticipated guilt were related to vaccine uptake intent. It postulated that hope and anticipated guilt mediated the relationships between risk perceptions/perceived benefits and vaccine uptake intent. The data were collected via an online survey of 460 Chinese participants in March 2021 and were analyzed using Hayes' PROCESS MACRO. The results revealed that perceived susceptibility and perceived benefits, but not perceived severity, predicted the Chinese's vaccine uptake intent. Furthermore, hope positively predicted vaccine uptake intent and partially mediated the relationship between perceived benefits and vaccination intent and between perceived severity and vaccination intent. Anticipated guilt was a significant, but weak predictor of vaccination intent. Both theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

The current research examines how risk appraisals of PM2.5 influence Chinese people's behavioral intentions to adopt government-recommended protective behaviors through negative affect. In testing the appraisal-based protective behavior model, this research also takes institutional trust and media sensationalism into account. An online survey is conducted with participants (N = 1,569) randomly drawn from heavily polluted Chinese regions. As predicted, negative affect mediates the effects of perceived susceptibility and perceived severity on individuals' intentions to take preventive measures against the PM2.5 risk. Institutional trust appears to increase people's behavioral intentions. However, media sensationalism decreases people's behavioral intentions. [ABSTRACT FROM AUTHOR]

Effective public health communication should take into the consideration how communicated risk perceptions might influence the public. Although many health behavior theories claim that high perceived risk likelihood motivates preventive health behaviors, this general prediction is complicated by different ways of estimating risk likelihood. Our review of 14 previous studies on perceived risk of infectious diseases revealed different measures of risk likelihood and inconsistent findings regarding the relationship between perceived risk likelihood and behavioral intention. Drawn from the review, we examined the predictive power of different types of risk likelihood on intention to prevent infectious diseases. Using two separate data sets, collected during the 2015 outbreak of the Middle East respiratory syndrome (N = 557) and the COVID-19 pandemic of 2021 (N = 1,001), we demonstrated that perceived risk likelihood that specifies future inaction on health behaviors (i.e., conditional absolute risk perception) better predicted behavioral intention than did other types of risk perceptions. When the effect of conditional absolute risk perception was controlled, the behavioral intention and unconditional absolute risk perception showed a negative relationship. The findings have theoretical and practical implications that can inform strategic communication during future outbreaks. [ABSTRACT FROM AUTHOR]

This study examined the risk preventive responses of individuals, especially those who do not adhere to preventive measures (e.g. anti-maskers) for COVID-19, by integrating three dominant theories in risk and health communication. The complex causal relationship between motivational elements and individualsʻ preventive behavior adoption was studied using Fuzzy-Set Qualitative Comparative Analysis. With a survey (N = 372) of non-abiding populations, this study found generalizable and unique configurations of motivational elements. Different effects of key motivational variables from three theories were found with different demographic factors. Theoretical and practical implications were also discussed. [ABSTRACT FROM AUTHOR]

Motivation-based message appeals and incidental emotions have the potential to encourage COVID-19 vaccination, especially when the motivation components of the two agree. Risk perception may also interact with self vs. other-oriented message appeals. Results from a 2 (message appeal) × 4 (incidental emotion) online experiment (N = 306) indicate that when exposed to an altruistic message, those who experienced self-transcendent emotions reported higher COVID vaccination intention than those amused or not induced with emotions. This effect, however, was not identified in the egoistic message condition. Risk perception was positively associated with self-vaccination intention but did not interact with message appeals. The main effect of risk perception and interaction effects between incidental emotions and message appeals provide important implications for addressing vaccine hesitancy and increasing vaccine uptake. [ABSTRACT FROM AUTHOR]

Research indicates that misperceptions that become part of people's initial mental models about an issue tend to persist and influence their attitudes even after the misperception has been corrected. Recent work on evolving mental models suggests that communication efforts about the ongoing COVID-19 pandemic and its aftermath may be improved by crafting messages that acknowledge biases and misunderstandings about the virus and other infectious diseases that may remain among members of the target audience. This study was designed to provide insight into such biases by: (1) establishing salient categories of COVID-related misperceptions in the earliest months of the pandemic in the United States among (a) the general population, and (b) demographic sub-populations at high risk of severe health outcomes; (2) identifying demographic predictors of misperceptions; and (3) examining the relationship between consumption of different television news outlets and agreement with misperceptions about COVID-19. A national sample of 1,000 adults in the United States (48.1% male; M age = 47.32, SD = 18.01; 72.9% White/Caucasian, 14.3% Black/African American, 15.9% Hispanic/Latinx) completed a survey between March 19 and March 25, 2020. Results identify prevalent classes of salient early COVID-19 misperceptions. Adjusting for numerous covariates, data indicated individuals over the age of 60 held the fewest COVID-related misperceptions among various demographic sub-populations, misperceptions were most prevalent among Black respondents, and increased consumption of television network news was associated with lower levels of misperception. Consumption of some 24-hour news networks (FOX and MSNBC) were significant positive correlates of misperceptions. [ABSTRACT FROM AUTHOR]

Although South Korea has been relatively successful in addressing the COVID-19 pandemic, there were controversies surrounding the negative social consequences (SC) associated with the infection, such as breach of privacy in contact tracing and stigmatization of patients. We examined how individuals' thinking about the SC of COVID-19 infection influenced preventive intention through this specific case, the early phase of the pandemic in South Korea (March, 2020) when concerns regarding SC were very high but vaccines were not available. We theoretically investigated the path from information exposure about COVID-19, worry and risk perception about SC of COVID-19, attitudes/norms/self-efficacy, and preventive intention. An online survey of 805 South Koreans revealed that information exposure about COVID-19 was positively associated with worry and risk perception about the SC, which indirectly predicted preventive intention through attitudes/norms/self-efficacy. As COVID-19 is a new disease, people learned about it from various sources, and contemplated (worry and risk perception) its negative social outcomes. To avoid such negative SC, they might have changed their beliefs toward preventive behavior, which influenced preventive intention. Given that both worry (affective–cognitive state) and risk perception (cognitive evaluation) are related to thinking activities, the findings suggest that individuals' thinking about negative SC of COVID-19 infection might have partly contributed to the success of the early South Korean quarantine model. However, the results also raise critical questions as to how we can protect individuals' lives during a public health crisis. [ABSTRACT FROM AUTHOR]

The adoption of the internet, social media, and e-cigarettes are on the rise among U.S. youth. Uses of social media and online platforms increase the probability for youth to encounter e-cigarette advertisements. Departing from this line of reasoning, we examine the underlying mechanisms of how online e-cigarettes exposure promotes youth's e-cigarette use. Drawing on insights from the social construction of risk model, this study looks at how perceived social norms and risk perception mediate the link between online e-cigarette advertisement exposure and e-cigarette use. Youth aged 12–17 from the Public Assessment of Tobacco and Health (PATH) Study Waves 2–4 (2014–2018) were included (N = 6,067). Controlling for demographic and other known risk factors for e-cigarette use, respondents who had been exposed to online e-cigarette ads at Wave 2 perceived higher levels of positive social norms of e-cigarette use at Wave 3 (β = 0.13, p <.001) which was associated with lower e-cigarette risk perception at Wave 3 (β = −0.22, p <.001). Lower e-cigarette risk perception at Wave 3 resulted in a higher likelihood of e-cigarette use at Wave 4 (AOR = 0.51, p <.001). Online e-cigarettes ads exposure at Wave 2 predicted e-cigarette use at Wave 4 (AOR = 1.87, p <.001). The results indicate that norm perception associated with online e-cigarettes ads may twist youth's e-cigarette risk perception that is associated with subsequent usage. Interventions to curb youth's e-cigarette use can target social norms of e-cigarette use and restrict e-cigarette advertisement exposure to youth. [ABSTRACT FROM AUTHOR]

Viewing government-public relationships as important antecedents of individuals' health protection behaviors, this study uses a relationship management approach to examine COVID-19 vaccine promotion among local government agencies. The study hypothesizes that the quality of local government-public relationships is positively associated with pro-vaccine outcomes, including more frequent risk information seeking, pro-vaccine attitudes, and greater vaccination intention. In addition, an important pathway through which the government-public relationship promotes vaccination acceptance is by enhancing the public's risk perceptions. Using a representative community sample, findings support the positive roles of certain but not all relationship quality variables in predicting vaccine acceptance. Meanwhile, risk perceptions consistently predict risk information seeking, pro-vaccine attitudes, and vaccination intention. [ABSTRACT FROM AUTHOR]

This study addresses how social media interaction affects misperceptions about COVID-19 via risk perceptions thereof and whether political orientation moderates the relationship. Using original two-wave panel survey data (N = 679), this study reveals that social media interaction increases misperception directly, as well as indirectly by reducing the extent of risk perception. The extent of risk perception is found to be a negative predictor of misperception. The deleterious role of social media interaction on misperception is pronounced across groups of conservatives and liberals, but in different ways. Although the effects of social media interaction on the level of misperception are observed in both conservatives and liberals, this relationship is particularly salient among conservatives. Furthermore, whereas conservatives consistently show low levels of risk perception toward COVID-19 regardless of how much they interact with others on social media, the more liberals interact on social media, the less likely they are to perceive COVID-19-related risks. The findings expand our understanding of the role of interaction behaviors on social media in forming risk perceptions and misperceptions on the politicized COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

A large body of research demonstrates that concussions are exceedingly common and extremely difficult to detect. Despite medical efforts to develop sophisticated tools to detect concussions, research continues to demonstrate that proper detection relies on prompt and thorough symptom reporting from the injured athlete. In the context of sports, such reporting requirements are complicated by systems that reward athletic performance. This study seeks to provide student athletes who play NCAA Division I high-contact sports with a theoretically driven intervention to improve their attitudes and behavior toward concussion reporting. Division I student athletes (N = 345) viewed one of three conditions: an NCAA handout consistent with current practices, the experimental video, or a non-treatment control video, then responded to questions regarding attitudes and behaviors toward concussion reporting. Overall, results support the video's effectiveness in changing perceptions of concussion injuries. Nuances of the findings lead to a discussion for practical implications to transform concussion-reporting attitudes and behaviors among athletes. [ABSTRACT FROM AUTHOR]

The purpose of this study is to seek an effective strategy to promote COVID-19 vaccination among young adults. Given that COVID-19 is less deadly for young adults, this study explores whether highlighting potential benefits or disadvantages that others may experience as a result of one's vaccination increases young adults' intention to get vaccinated, particularly for those who have low perceived risk of COVID-19. To test this idea, we conducted an experiment and analyzed the effect of interaction between message frame (gain vs. loss) and reference point (self vs. others) on intention for vaccination by one's perceived risk (low vs. high). The results show that for those with low perceived risk of COVID-19, messages about potential negative consequences to others (e.g., family, friends, community members) from one's failure to get vaccinated led to message elaboration and favorable attitude toward vaccination, which in turn promoted one's intention to get vaccinated. We discuss practical implications of the findings for message strategies that target populations experiencing COVID-19 disparities. [ABSTRACT FROM AUTHOR]

As one of the biggest challenges facing mankind in recent history, the COVID-19 pandemic has had profound impact on the United States. However, government responses ranging from stay-at-home orders to temporary closing of nonessential businesses are not palatable for everyone. This study examines how cultural cognition, risk perception, and discrete emotions influence Americans' support for COVID-19 responses. We found that compared to communitarians and egalitarians, individualists and hierarchists were less likely to support COVID-19 responses. In addition, fear and anger mediated the relationship between risk perception and public support in the opposite direction. The highlight of this study is the moderating role of cultural cognition. Specifically, individualistic worldviews significantly moderated anger's mediation effect on the relationship between risk perception and support for COVID-19 responses. [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]

HPV has long been constructed as a sex-specific virus. Boys and men largely perceive the virus as not related to themselves and thus develop a female-specific schema on HPV. The present study investigates message strategies for promoting HPV vaccination among heterosexual young men in the United States. Through an online experiment, this study examined the effects of reference point (self, other, vs. self-other) and message framing (gain vs. loss) on processing fluency, optimistic bias, and behavioral intentions. The findings showed a schema-matching pattern in facilitating information processing, and a schema-mismatching pattern in attenuating optimistic bias. Specifically, other-referencing messages that related the outcomes of getting vaccinated for HPV to the message recipients' sexual partners promoted processing fluency and widened the self-other gap in perceived susceptibility to HPV, regardless of the message frame. By contrast, self-other-referencing messages that highlighted the outcomes regarding themselves and their sex partners enhanced processing fluency and mitigated optimistic bias. Moreover, the attenuation in optimistic bias increased the participants' information seeking intentions and the likelihood that they would share the messages on social media. The implications for health message design are discussed from a schema-based, message-tailoring perspective. [ABSTRACT FROM AUTHOR]

To identify the psychosocial determinants of individuals' intention to engage in collective actions against cancer, we extended and tested the risk perception attitude (RPA) framework at the level of social perceptions. The results of a large online survey of Hong Kong citizens (N = 1,005) revealed that perceived societal risk and perceived collective efficacy directly and jointly influenced respondents' intention to engage in collective actions against cancer, namely donating to cancer charities, volunteering at cancer-prevention organizations, and supporting public policies for cancer prevention. However, the interaction between perceived societal risk and perceived collective efficacy occurred in a direction opposite to the direction in the initial RPA framework. As suggested by the framework, we also categorized individuals into four attitudinal groups based on their perceptions of societal-level risk as well as efficacy and compared their demographic and psychological characteristics. Among the findings, the four groups significantly differed in their perceptions of individual-level risk as well as efficacy, in their family cancer history, and in their intentions to engage in individual-level behaviors to prevent cancer. Altogether, our findings contribute to the literature by extending the RPA framework to individuals' societal-level perceptions and by providing evidence that the framework can benefit the development of health communication campaigns to promote engagement in collective actions to support cancer prevention. [ABSTRACT FROM AUTHOR]

Integrating the extended parallel process model (EPPM) and the emotional flow hypothesis, we tested the persuasive effect of emotional shifts during exposure to a Know the Truth anti-opioid campaign narrative in a sample of middle-school students (n = 480). Testing two emotional flow sequences (threat to efficacy and efficacy to threat) of the Know the Truth narrative against a static (threat-only) emotional condition, we found that youth exposed to any emotional flow narrative reported higher levels of hope and lower levels of fear than those exposed to a threat-only narrative. We also found that a threat to efficacy narrative elicited higher levels of self-efficacy than an efficacy to threat emotional flow condition, suggesting that the emotional sequence influences self-efficacy, a well-established predictor of health behavior change. We conclude that the traditional threat to efficacy emotional flow may be superior to its inverse (efficacy to threat) when communicating with young people about opioid addiction. Implications for message design are discussed. [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]

The global pandemic caused by SARS-CoV-2 (COVID-19) poses serious health risks to humans; yet, despite recommendations by governments and health organizations, a significant number of Americans are not engaging in preventive behaviors. To understand and explain this phenomenon, we seek guidance from a theoretical model that merges the risk information seeking and processing model and the theory of planned behavior. Furthermore, given the politicized nature of the pandemic in the U.S., we pose different information seeking patterns according to media partisanship, asserting that partisanship is likely to affect cognitive structures regarding COVID-19 decision making. Our results suggest two distinct routes for information seeking to decision-making. Conservative media use is directly associated with preventive behavior avoidance, while liberal media use is indirectly associated with preventive behavior engagement. This work contributes to our collective understanding of what drives preventive behaviors in the context of health risk, particularly in the case of a highly politicized national health crisis with global implications. [ABSTRACT FROM AUTHOR]

Despite mixed findings in the literature, health information seeking is considered as a promising antecedent of health behavior and outcome. However, little research has been conducted to identify factors that explain the health information seeking-health behavior relationship. In the contexts of breast, cervical, and prostate cancer screening, this research utilized recently collected Health Information National Trends Survey data (HINTS 5 Cycle 1) to examine whether, among the population at risk of cancer, previous cancer information seeking influenced cancer screening via perceptions of risk and efficacy, desired uncertainty, and worry. The results indicated that previous cancer information seeking had a direct effect on cancer screening. Across the three cancer screening behaviors, desired uncertainty mediated the relationship between previous cancer information seeking and screening behavior. Worry about getting cancer moderated and mediated the relationship between cancer information seeking and cervical cancer screening. Moreover, desired uncertainty and perceived susceptibility respectively interacted with previous cancer information seeking to influence breast cancer screening. Perceptions of risk and efficacy had limited effects on cancer screening. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

This proof-of-concept study aims to evaluate the effect of placing graphic health warning labels (GHWLs) on the ENDS device on users' experience, puffing patterns, harm perception, nicotine exposure, and intention to quit or use in the future. JUUL users (n = 26, age 18–24 years; 69% male; 85% Hispanic) were recruited to complete two 60 minutes ad libitum sessions that differed by GHWL on the device (GHWL vs. no-GHWL control) in an experimental clinical lab study. Compared to the control session, using JUUL with GHWL on the device was significantly associated with reduced positive experiences such as pleasure, product liking, and user satisfaction (p-value < 0.05 for all). Also, after exposure to GHWL, participants were less interested in using the same product again (p-value = 0.007), even if it was the only product available on the market compared to control (p-value = 0.03). Trends toward reduced puffing behavior and nicotine boost were also noted during the GHWL, compared to control sessions. This pilot study shows that placing GHWL on the ENDS device may be an effective and promising strategy to reduce ENDS use among young people. [ABSTRACT FROM AUTHOR]

Using Galileo theory and method of multidimensional scaling (MDS), we compared the psychological distances between concepts related to two pandemic viruses, Zika and COVID-19. Surveys (Zika, N = 410; COVID-19, N = 291) were used to investigate the role of media use and interpersonal communication on the relationship between 10 concepts in multidimensional spaces. We asked these four research questions: Do the two spaces represent the two pandemics similarly? What is the relationship of me and of people to each pandemic? What is the effect of virus-related media use and interpersonal talk on the pandemic space? What are optimal messages for moving me closer to Zika and to COVID-19? Media use influenced the distances for both pandemics: With greater media use, the concepts were closer in the Zika space and further apart in the COVID-19 space. Interpersonal communication was associated with few differences in the spaces. Based on the psychological distances between concepts, optimal messages were identified: For Zika, a message with two concepts, people and women, is predicted to be most effective to move Zika to the concept me, whereas for COVID-19, a message with people is predicted to be most effective to move COVID-19 to me. [ABSTRACT FROM AUTHOR]

Risk perception is a critical determinant for individuals' health behavior change, especially for behaviors with distal future consequences. Building on construal-level theory, this study investigates if and how thinking concretely about the negative consequences of opioid misuse influences people's risk perception toward opioid misuse. Two message cues – images and concrete (vs. abstract) language – are proposed to influence concrete thinking and perceived temporal distance, which in turn influence risk perception directly and through negative affect. Using a factorial online experiment with Amazon Mechanical Turk workers (N = 220), this study found that messages using concrete language made people think more concretely about the negative consequences of opioid misuse. Perceived concreteness, in turn, increased risk perception and negative affect. Negative affect also increased risk perception. The use of images decreased perceived temporal distance, which in turn, changed risk perception through its influence on negative affect. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

To better understand the processing of e-cigarette prevention messages, we conducted a content analysis of 1,968 participants' open-ended responses to one of four messages, which focused on industry manipulation (Big tobacco), financial and psychological cost of vaping (Can't afford), harmful chemicals in e-cigarettes (Formaldehyde), or uncertainty about the ingredients of e-liquids (Top secret). Health Belief Model (HBM) and perceived message effectiveness (PME) constructs were coded and the frequency of each variable was compared across message conditions. Among the HBM constructs, perceived health threat had the most mentions overall (38.8%). Self-efficacy of staying away from vaping had the fewest mentions across all messages (0.56%). For PME, participants more frequently mentioned message perceptions (15.75% positive message perceptions, 8.38% negative) than effect perceptions (3.46% positive effect perceptions, 1.37% negative). Big tobacco received the highest number of mentions for positive message perceptions and Formaldehyde received the highest number of mentions for positive effect perceptions. Future anti-vaping messages are recommended to address the efficacy element and to combine different themes to communicate harms of e-cigarettes. [ABSTRACT FROM AUTHOR]

Public health communication has long been a key component of tobacco control efforts. However, little is known whether and how such an effort could address disparities in tobacco risk perceptions among population subgroups. In this study, using data from the Global Adult Tobacco Survey of Ethiopia, we examined if tobacco risk perceptions varied across socioeconomic and urban vs. rural population subgroups, and whether and how exposure to anti-smoking message was associated with disparities in risk perceptions across socioeconomic and urban-rural subgroups. The results indicated that health risk perceptions of smoking and secondhand smoke exposure were significantly lower among rural, less educated and less affluent population subgroups. Controlling for age, gender, education, wealth, place of residence, and pro-smoking message exposure, anti-smoking message exposure was associated with greater risk perceptions of smoking. Moreover, anti-smoking message exposure moderated the associations of place of residence and education with risk perceptions of smoking and secondhand smoke exposure, respectively. The probability of risk perception of smoking associated with anti-smoking message exposure was higher among the rural populace compared to urbanites. Similarly, the probability of risk perception of secondhand smoke exposure associated with anti-smoking message exposure was the highest among individuals without formal education compared to those with primary, secondary, and college-level education. The findings suggest that efforts should be made to make sure adequate anti-smoking message exposure among less educated and rural audiences so as to reduce disparities in tobacco risk perceptions. [ABSTRACT FROM AUTHOR]