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Vaccines (a medical product) and vaccination recommendations (expert advice on who should receive, when, and how often) have grown in importance and prominence in the past 15 years, including because of a recent COVID-19 pandemic. This essay highlights contributions from vaccine and vaccination-related health communication research since 2010. This research has had significant impacts – that is, visible and discernible positive effects – on the ways health communication is undertaken broadly (e.g. at the campaign level) and at the health care provider-patient level (e.g. conversations with parents and patients regarding vaccine benefits, risks, and safety). As this essay illustrates, health communication research has resulted in greater use of formative research to guide vaccination campaign and education efforts, better identification and understanding of the factors behind vaccination delay and declination, and greater recognition that communication efforts can fail to achieve desired outcomes or generate unintended consequences. Health communication research has also documented the powerful influence of healthcare provider communication on parent and patient understanding and compliance with immunization recommendations. Importantly, this research has also shown the characteristics of provider-patient communication matter much. Healthcare providers must have or establish a high degree of trust, be well-versed in vaccine efficacy and safety, and be adept at using their personal experiences, information tailoring/personalization, and evidence-based communication strategies to increase the likelihood of success. [ABSTRACT FROM AUTHOR]

Although much attention has been given to vaccine hesitancy, there is still considerable ambiguity regarding its epistemological antecedents. The current meta-analysis addresses this theoretical and practical gap by focusing on the interplay between trust, belief in conspiracy theories, and COVID-19 vaccine hesitancy (k = 32), as well as key moderators such as the availability of the vaccine and the state and progress of the pandemic. Overall, results indicate that while both trust and beliefs in conspiracy theories are important correlates of vaccine hesitancy, considerable difference emerges when adopting a more granular approach that distinguishes between types of trust (government, public health organizations, science, and healthcare professionals/providers) and conspiracies (specific versus general). These findings cement the importance of health communication, not only as a useful framework to study and understand vaccine hesitancy but also as a potential way to intervene in order to prepare for future infectious disease outbreaks. [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]

Rooted in the emotions-as-frames model (EFM), this research examines how hope, fear, and annoyance are evoked through health news headline scanning, and how these emotions influence perceptions of news and medical science institutions as well as health behavioral intentions. A sample of U.S. adults (N = 327) were assigned to one of four headline framing conditions expected to associate with different emotions (positive future frame-hope; threat frame-fear/anxiety; reversal frame-annoyance; and control-neutral) and then asked about their emotional states, trust in science and news, and health-related behavioral intentions. Overall, health news headlines generated more hope than any other emotion across all conditions, and positive future-framed headlines evoked more hope than other framed headlines. Felt hope, in turn, generated greater trust in news and science, higher expectations of medical breakthroughs and cures, and greater intention to engage in preventative health behaviors. Felt anxiety had marginal positive benefits whereas felt annoyance negatively impacted the outcomes of interest. Notably, felt emotion mediated the headline frame-outcome relationships in the positive future/hope condition. These findings offer some support for the EFM and demonstrate that scanning headlines imbued with specific emotional frames can influence important health-related outcomes through the emotions they evoke. We discuss both the theoretical and practical implication of these findings. [ABSTRACT FROM AUTHOR]

Although news and entertainment coverage of sports concussions has increased in recent years, many parents of adolescent athletes remain indifferent to or unaware of practices that would mitigate concussion harm. This experiment with U.S. parents of 10- to 17-year-olds (N = 502) explores how narratives and expository concussion science could be used together to increase concussion risk assessments, mitigation intentions, and support for sports concussion policy. Direct and indirect relationships through narrative transportation and trust are explored. [ABSTRACT FROM AUTHOR]

Despite the agreement on the importance of two-way communication during governmental response to pandemics, few studies provided empirical evidence to support the effectiveness of such communication strategy in times of a public health crisis. Integrating the concept of two-way symmetrical communication and the Trust, Confidence, and Cooperation model (the TCC model), this study investigates how strategic communication practices, in particular two-way symmetrical communication, is related to public's perceived trust and confidence in governments (i.e., CDC in this study), and how these perceptions may affect decisions to comply with the preventive behaviors (i.e., face covering in this study), while taking the moderating role of knowledge into consideration. An online survey was conducted with 502 participants who were living in the United States in early April 2020. The findings showed that two-way symmetrical communication may increase public trust and confidence in governments, and improve individuals' knowledge about the pandemic, which all subsequently leads to compliance with recommended behaviors. The results contribute to the theoretical understanding of pandemic communication and provide implications for practitioners in pandemic management, suggesting that health institutions should adopt two-way symmetrical communication practices in respond to public health emergencies. [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]

The fact that social media gives users easy access to online health information raises the question of what information evaluation strategies older adults use to distinguish trustworthy from unreliable health information. Identifying how older adults assess the credibility of health information that they acquire on social media is an important step toward understanding and reducing their susceptibility to health misinformation. In this study, we investigated the credibility assessment strategies used by older WeChat users in China. Following a qualitative approach, we conducted in-depth interviews with 40 WeChat users 65–85 years old (M = 71.75, SD = 6.65) in China who had acquired health information on WeChat. Results of theoretical thematic analysis revealed five source-based and content-based evaluative strategies: (1) determining the communicative orientation of the source, (2) assessing source reputation, (3) confirming content based on life experiences, (4) checking for exaggeration in claimed effects, and (5) assessing the consistency of content across sources. Older WeChat users' reliance on certain heuristic cues and their self-reliant approach to assessing information credibility provide contextual explanations for the link between heuristic processing and susceptibility to health misinformation. The findings have implications for anti-misinformation interventions targeting the older population in China and potentially beyond. [ABSTRACT FROM AUTHOR]

During the COVID-19 crisis, many social media influencers (SMIs) discussed the pandemic on their channels and showcased their behavior in dealing with the virus. Drawing on the two-step flow of communication and social learning theory, we investigated the attitudinal and behavioral consequences of SMIs' COVID-19-related communication in a two-wave panel survey among emerging adults aged 16–21 years (NT1 = 978, NT2 = 415). Our results contribute to the health communication literature by discovering that institutional mistrust determines whether young people resort to SMIs as an information source for COVID-19-related information. Those with higher mistrust in established media organizations and the government were more likely to consult SMIs for COVID-19-related information and to consider them as role models when exposed to relevant content. Moreover, consulting SMIs who promote noncompliance as a COVID-19 information source was over time related to lower vaccination intentions. [ABSTRACT FROM AUTHOR]

Patient-centered care and healthcare consumerism are dominant models of the patient-provider relationship. Positioning theory was applied to examine consumers’ and physicians’ positions on patient-centered care and healthcare consumerism, along with their attitudes toward direct-to-consumer healthcare service advertising and trust in the medical profession. Surveys were conducted with a convenience sample of consumers and physicians respectively. Patient-centered care was the only theoretical construct that both consumers and physicians unequivocally embraced. Both groups were either ambivalent or skeptical of the other three concepts. Between the two groups, physicians exhibited a stronger endorsement of patient-centered care and more negative attitudes toward advertising than consumers. When the relationships among the theoretical constructs were examined, a negative correlation between patient-centered care and consumerism was found among consumers. Also, patient-centered care and trust were negatively correlated in both groups. Implications of these findings are discussed for strategic communication, consumer and physician education, and future research. [ABSTRACT FROM AUTHOR]

Guided by theories of communicative disenfranchisement (TCD) and memorable messages (ToMM), this study analyzes 60 open-ended survey responses detailing experiences of grief following the onset of invisible, physical illness (e.g., chronic overlapping pain conditions, autoimmune rheumatic diseases). Employing reflexive thematic analysis, we identify (1) illness-related losses that are disenfranchised by discourses surrounding grief and (2) opportunities to enfranchise these losses via memorable messages. Situated at two points in time, before and after the onset of illness, we identify disenfranchised losses as what once was (e.g., physical [in]dependence, relational connection, images of self, and trust in institutions) and what will never be (e.g., family planning and career dreams). Next, we identify opportunities to disrupt this disenfranchisement through memorable messages of presence (e.g., nonverbal acknowledgment and verbal expressions of belief) and finding the fit (e.g., physical restructuring and community connection). In doing so, we extend theoretical understanding of both memorable messages, in the form that they can take (of experience) and as points of (dis)enfranchisement, and communicative (dis)enfranchisement. This study contributes to a growing body of health communication research on disenfranchising experiences in chronic illness by highlighting a resulting experience of illness not often talked about – illness-related loss and its grief process. Theoretical and practical implications, as well as limitations and future directions, are discussed. [ABSTRACT FROM AUTHOR]

Engaging the public and community organizations in local health actions greatly assists disease prevention and control. However, it remains unclear how organization-public relationships (OPR) and communication networks within communities contribute to community health actions. To fill this gap, a survey was conducted among community members in Shanghai, China, who were challenged by the Omicron wave of the COVID-19 pandemic. Results revealed that integrated connectedness to a storytelling network (ICSN) was a significant predictor of residents' community engagement. Trust, control mutuality, commitment, and ICSN were positively associated with community engagement intentions through the sense of community and organizational efficacy. This study is a step toward understanding how organizations and members collectively respond to health crises at the community level. [ABSTRACT FROM AUTHOR]

Earning digital badges to showcase a person's expertise or knowledge are becoming increasingly popular. A healthcare provider's displaying of a Safe Zone badge within their online profile may offer prospective patients a cue as to the kind of care they might receive if they selected that particular provider. Prior research indicates LGBTQ+ individuals are looking for these types of cues within providers' biographies to make their selections. A between subjects, 2 (Safe Zone badge present/absent) x 2 (male/female doctor) online experiment was conducted (n = 658). Results revealed a main effect for the presence of the Safe Zone badge. Participants had greater anticipated satisfaction, liking, were more likely to view the provider as approachable, and were more willing to schedule an appointment with the provider displaying a Safe Zone badge. [ABSTRACT FROM AUTHOR]

Care provider communication with Black birthing families is impactful. This cross-sectional study asked 216 Black fathers to recall treatment by birthing care providers and tested variables contributing to birth satisfaction and fathering identity salience. Most fathers reported that care providers were respectful resulting in a positive birthing experience; however, 15% reported negative experiences with care providers. Perceived social support was shown to be a mediator between disrespect, mistreatment, inclusive communication, trust, and positive emotion with birth satisfaction and fathering identity salience. Care provider disrespect served as a "spoiler" of the birthing experience and subsequently diminished positive fathering identity salience. Analysis of open-ended comments showed that contrary to stereotypes about absent, disengaged Black fathers, fathers in this study were caring toward their newborns, present for them, and engaged in fathering. More work needs to be done with care provider communication to make every birth a positive and inclusive experience for Black fathers and their partners. [ABSTRACT FROM AUTHOR]

Youth offer valuable insight on health communication needs and solutions in their communities. We propose youth participatory action communication research (YPACR) as a model for health campaign development that engages youth perspectives in applying systematic theory-informed communication research to addressing youth-identified health priorities. YPACR informed a series of paid high school internship programs in West Philadelphia, in which youth interns identified mental health help-seeking communication as a need among peers. In Phase 1, guided by the reasoned action approach and Hornik & Woolf method, youth interns conducted a survey measuring behavioral beliefs, normative beliefs, and control beliefs associated with mental health help-seeking, as well as trusted sources of mental health information, among local high school students. Survey results suggested control (self-efficacy) was an important message target and peers were trusted mental health information sources. In Phase 2, youth interns developed TikTok-style messages focused on strengthening control beliefs and promoting a youth-selected mental health support resource. Youth interns distributed an online survey experiment to test whether youth-created messages shown alongside resource information increased help-seeking self-efficacy compared to an information-only control. The YPACR framework contributed to youth-relevant campaign goals, study measurements, recruitment approaches, data interpretation, and message design. We discuss the benefits and challenges of this youth-driven health campaign development model and recommendations for future research. [ABSTRACT FROM AUTHOR]

The doctor-patient relationship in China has become increasingly tense, with patients lacking trust in doctors. Meanwhile, online healthcare flourished, accelerated by the COVID-19 pandemic. This study utilized the direct and indirect pathway model of clinician-patient communication to health outcomes and online trust theory to examine the associations between online patient-centered communication (OPCC), benevolence and ability trust in doctors, negative online health information seeking experiences, and willingness to recommend doctors. The findings revealed that benevolence and ability trust mediated the relationship between OPCC and willingness to recommend doctors. Additionally, when participants had a high level of negative online health information seeking experiences, OPCC had a stronger effect on ability trust; meanwhile, the mediation effect of ability trust between the relationship of OPCC and willingness to recommend was stronger. This study also discussed theoretical and practical implications. [ABSTRACT FROM AUTHOR]

Despite increasing research that examines language features of online medical consultation (OMC) conversations in China, limited attention has been directed to how medical professionals purposefully present themselves in their biographies on OMC websites, an emerging genre of health communication, with even fewer comparative studies on traditional Chinese medicine (TCM) and Western medicine (WM) medical professionals in this regard. To fill these gaps, this study compares the personal claims and self-presentational strategies used in TCM and WM medical professionals’ biographies on a Chinese OMC website. It is found that while Chinese TCM and WM medical professionals present themselves in similar ways, they also demonstrate some important differences. The similarities may be driven by their shared goal of building trust in the OMC context, whereas the differences may be ascribed to TCM-WM differences in clinical philosophies, education histories, clinical cultures, and medical practices. [ABSTRACT FROM AUTHOR]

This manuscript focuses on the communication factors that affect the willingness of African Americans and Black Caribbean patients to participate in clinical trials and research studies. Low rates of research participation by members of communities of color have long been linked to health disparities. While there are many factors that contribute to low rates of accrual of African American and Black patients to clinical trials, a lack of attention to communication factors that enhance or inhibit the recruitment process is central to the problem. In this study, we describe results from the analysis of six focus groups (N = 31) consisting of African American (k = 3) and Black Caribbean (k = 3) participants. Our analyses focus on verbal and nonverbal communication behaviors and how they affect participants' willingness to participate in clinical trials. Specifically, when clinical research coordinators (CRCs) had a professional appearance, made the effort to explain a study in detail, made eye contact, took the time to listen and answer questions patiently, and gave the sense that the CRC was being truthful and transparent, patients felt respected and valued. Additionally, participants emphasized the importance of the process of developing and maintaining a trusting relationship between study participants and CRCs. The results of this study will be used to develop a clinical trial communication training program designed to enhance the communication skills of clinical research coordinators who discuss research participation with African American and Caribbean Black patients. [ABSTRACT FROM AUTHOR]

This experimental study investigates the effects of several heuristic cues and systematic factors on users’ misinformation susceptibility in the context of health news. Specifically, it examines whether author credentials, writing style, and verification check flagging influence participants’ intent to follow article behavioral recommendations provided by the article, perceived article credibility, and sharing intent. Findings suggest that users rely only on verification checks (passing/failing) in assessing information credibility. Of the two antecedents to systematic processing, social media self-efficacy moderates the links between verification and participants’ susceptibility. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Despite being high health care utilizers, many women Veterans perceive their pain condition to be poorly understood by their providers, which can be a strong demotivator for seeking care. We set out to understand the priorities rural-dwelling women Veterans have for using health care for their chronic pain, and interviewed participants about their experiences with (and priorities for seeking) health care for their chronic pain. Self-Determination Theory identifies three sources of motivation (autonomy, competence, relatedness), all of which were represented through two themes that reflect rural women Veterans’ rationale for decision-making to obtain health care for chronic pain: role of trust and competing priorities. Women described their priorities for chronic pain management in terms of their competing priorities for work, education, and supporting their family, but most expressed a desire to function in their daily life and relationships. Second, women discussed the role of trust in their provider as a source of motivation, and the role of patient-provider communication skills and gender played in establishing trust. Rural women Veterans often discussed core values that stemmed from facets of their identity (e.g. gender, military training, ethnicity) that also influenced their decision-making. Our findings provide insight for how providers may use Motivational Interviewing and discuss chronic pain treatment options so that rural-dwelling women Veterans feel autonomous, competent, and understood in their decision-making about their chronic pain. We also discuss importance of acknowledging the effects of disenfranchising talk and perpetuating gendered stereotypes related to chronic pain and theoretical implications of this work. [ABSTRACT FROM AUTHOR]

This study examines providers' perceptions of provider-patient communication in reproductive endocrinology and infertility (REI) practices. Grounded in narrative medicine, we interviewed six REI providers about their experiences providing fertility care. REI providers crafted a narrative of bearing witness by (1) situating personal and professional self in REI narratives, (2) sharing news as important medical moments, and (3) cultivating affiliation between provider and patient. These findings offer insight into the power of narrative medicine in fertility care, the role of emplotment in narrative sense-making, and the emotional labor associated with information delivery in REI treatments. We offer several recommendations for how patients and providers can improve communication experiences in REI. [ABSTRACT FROM AUTHOR]

Epistemic trust – i.e. the belief in knowledge claims we do not understand or cannot validate – is pivotal in healthcare interactions where trust in the source of knowledge is the foundation for adherence to therapy as well as general compliance with the physician's suggestions. However, in the contemporary knowledge society professionals can no longer count on unconditional epistemic trust: boundaries of the legitimacy and extension criteria of expertise have become increasingly fuzzier and professionals must take into account laypersons' expertise. Drawing on a conversation analysis-informed study of 23 videorecorded pediatrician-led well-child visits, the article deals with the communicative constitution of healthcare-relevant phenomena such as: epistemic and deontic struggles between parents and pediatricians, the local accomplishment of (responsible) epistemic trust, and the possible outcomes of blurred boundaries between the layperson's and the professional's "expertise." In particular, we illustrate how epistemic trust is communicatively built in sequences where parents request the pediatrician's advice and resist it. The analysis shows how parents perform epistemic vigilance by suspending the immediate acceptance of the pediatrician's advice in favor of inserting expansions that make it relevant for the pediatrician to account for her advice. Once the pediatrician has addressed parents' concerns, parents perform (delayed) acceptance, which we assume indexes what we call responsible epistemic trust. While acknowledging the advantages of what seems to be a cultural change in parent-healthcare provider encounters, in the conclusion we advance that possible risks are implied in contemporary fuzziness of the legitimacy and extension criteria of expertise in doctor-patient interaction. [ABSTRACT FROM AUTHOR]

Neglecting the role of political bias in the public's perceptions of health authorities could be deceptive when studying potentially politicized COVID-19 conspiracy theories (CCTs); however, previous studies often treated health authorities as a single entity and did not distinguish between different types of CCTs. Drawing from motivated reasoning theory, we investigate the politically motivated nature of CCTs by examining their associations with individuals' media reliance, party identification, conspiratorial mentality, and importantly, trust in (politicized or independent) health authorities. In a national survey conducted in late 2020 (N = 2,239) in Turkey, a heavily polarized context, we found that not accounting for political identities shown in CCTs and health authorities could be misleading. While those with a strong conspiracy mentality were more likely to endorse all types of CCTs, party identification and trust in different types of health authorities led people to believe in certain CCTs aligning with their political attitudes. The influence of media reliance on CCTs depended on the level of trust in health authorities, again suggestive of the influence of political partialities. [ABSTRACT FROM AUTHOR]

This study examined the formation of trust judgments of information sources about COVID-19 and the role played by emotions in this information seeking process. Twenty-seven in-depth interviews with Americans revealed that both trust and affective responses were present in information seeking of health messages, thus discovering the applicability of Risk Information Seeking and Processing (RISP) model’s propositions during pandemics. Using qualitative methods to assess RISP variables in a new context (COVID-19), the study proposes modifications to the existing model. It also extends the sociopsychological traditions on which the RISP model was based, by finding that when evaluating information sources during pandemics, under conditions of high issue relevance, individuals’ peripheral evaluation of messages might precede systematic evaluation and might be used as a selection criteria for further elaboration. Finally, the assessments of source credibility as a peripheral cue in this study expand current theoretical understandings by including compassion as a possible new dimension. [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]

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]

The COVID-19 pandemic has challenged existing health communication strategies as more people turn to social media as a primary health information source. Although many studies have explored how young people use social media, this study examined how sociodemographic factors and political ideology are associated with use and trust in social media as a source for COVID-19 information among young adults, and how use and trust in social media as a COVID-19 information source are associated with their beliefs about COVID-19. In Spring 2021, an online survey was conducted among 2,105 18–29-year-old students at an urban university in California. Our findings show that younger, female, non-binary, Asian, and Black/African American students are most likely to obtain and trust COVID-19 information on social media. Results also suggest that liberal students are more likely to turn to social media as a source for COVID-19 information compared to conservatives. However, conservative students who use social media as a source for information were more likely to believe false health information about prevention measures and the vaccine and to have lower perceived effectiveness of COVID-19 prevention behaviors and vaccination compared to liberals. [ABSTRACT FROM AUTHOR]

Public health messages disseminated by trusted government authorities are likely to have more influence over individuals' intentions and behaviors. However, individuals worldwide have different levels of trust in government authorities, which leads to varying levels of compliance intentions. Additionally, these trust levels may vary during major public crises, such as pandemics. Based on a COVID-19 pandemic communication survey (N = 3,065) disseminated throughout six countries (Australia, Finland, Italy, South Korea, Sweden, and the United States), this study examined the association among trust in distinct government sources, cultural orientations, and health behavioral intentions. Findings indicated that trust in official health communication sources at four governmental levels (i.e. national government, the head of the national government, the national health authority, and the chief representative of the national health authority) was related to vaccination intentions and other behavioral compliance intentions (i.e. willingness to prevent COVID-19 infection in other ways). Meanwhile, these direct associations were mediated by the cultural orientations of power distance and uncertainty avoidance. Findings also revealed that the direct association of trust in government sources and the indirect relationship through the above cultural orientations varied by country. This study offers insight into the important role of credible sources and individuals' cultural orientations in the domain of health communication aimed at influencing behavioral intentions. [ABSTRACT FROM AUTHOR]

The surge of health misinformation on social media poses a threat to public health. This qualitative study reports how users process health misinformation from the dominant strong-tie social media, WeChat, in China. We conducted ten on-site focus groups involving 76 adult participants. Drawing on the apomediation theory and the dual processing model of credibility assessment, we found the heuristic approach to processing health information was the dominant route of engagement. We identified four categories of credibility assessment cues, including (1) expertise, authority, and commercial intent of original sources, (2) expertise of apomediaries (i.e. social media information sharers) and generational bias, (3) clickbait and sensational content versus objective scientific style, and (4) disconfirmation versus confirmation bias. We highlight that apomediaries are playing an increasingly important role in informing credibility judgment. Specifically, younger adults have formed a generational bias of deeming older apomediaries as cues of lower credibility. [ABSTRACT FROM AUTHOR]

This study proposes that in order to increase compliance with government directives during health crises, we should consider the message as well as the messenger. Prior research shows that highly instructional crisis communication increases compliance during acute crisis situations. Crisis communication literature provides no clear answers on how to address prolonged crises like the COVID-19 pandemic, however. We examined the impact of crisis communication on compliance with health directives in March – April 2021, during the third wave of the pandemic in Belgium. Two field experiments were conducted at two different points in time. Participants received an informational message from Belgian authorities, that was either highly instructional or not. Next, they watched a set of messages from traditional and social media, depicting Belgian politicians setting a good or a bad example in terms of adhering to public health directives. Instructional messages only proved to be effective in the first study. Leading-by-example had a stronger impact, especially in study two. During the third wave of COVID-19, Belgian people seemed more inclined to follow public health directives when politicians set the right example, due to an increase in trust in the government. Bad examples, however, decreased compliance. [ABSTRACT FROM AUTHOR]

This study conducted an experiment to examine the impact of informational conflicts about COVID-19 transmission routes on cognitive and behavioral factors. We were guided by the risk information seeking and processing model and focused on relationships among perceived ambiguity, information insufficiency, trustworthiness, and seeking/avoidance across several conditions. Data from 304 participants indicated a higher level of perceived ambiguity in the conflicting information condition compared to the one-sided information condition. The serial mediations suggest conflicting information enhanced perceived ambiguity, which was negatively related with trustworthiness of experts, information seeking, and adherence intentions. These findings shed light on how conflicting information negatively affects the decision-making process and provide insight about what to consider when presenting dynamic information to the public. [ABSTRACT FROM AUTHOR]

As frontline providers, first responders are not always thought of as patients with unique health beliefs. During early and continued distribution, many first responders in the United States chose to refuse vaccination. Guided by the health belief model and emerging research related to SARS-COV-2, the aim of this study was to further explore the complex message conditions that contributed to first responders' early vaccination decisions. An online survey was conducted between March 1 and March 31 2021, among first responders in the state of Kentucky, which has lagged behind most states in the percentage of the population who are fully vaccinated. The first responder sample included Firefighters, Emergency Medical Technicians (EMTs), and paramedics who completed a Qualtrics survey that included measures aimed at assessing health beliefs about SARS-COV-2, beliefs about SARS-COV-2 vaccines, source trustworthiness, and vaccine motivation. First responders were also asked to rank the importance of various information sources about SARS-COV-2 and its vaccines. Findings suggest significant differences exist among first responders who have chosen to receive SARS-COV-2 vaccines and those who have refused, including source preference, conspiracy beliefs, and perceived risk. Future directions, including the exploration of institutional mistrust as a health belief are discussed. These findings offer practical insights that may improve continuing approaches to discover and use preferred communication sources to reach the vaccine-hesitant. [ABSTRACT FROM AUTHOR]

Effective risk communication is critical to gain public support when implementing population-level health interventions. Analysis of previous public health campaigns can provide guidance for future efforts. This case study examined a successful community water fluoridation campaign in Saskatoon, Canada, during 1953/54. The key strategies and messaging used by both sides of the debate were assessed using two publicly available historic data sources: documents in the city archives and newspaper coverage. The anti-fluoridation campaign approaches (e.g. misinformation, innuendo, half-truths and scare words, requesting a plebescite) were similar to those used elsewhere by this movement as described in the literature. Key features of the effective pro-fluoridation campaign included extensive community outreach, involvement of local experts, dissemination of supporting evidence while aggressively addressing misinformation, highlighting the support of relevant health organizations, and ensuring key messages received media coverage. This study illustrates how misinformation and public opposition has posed a challenge to public health efforts long before the advent of social media and highlights strategies, consistent with current risk communication principles, that have stood the test of time. [ABSTRACT FROM AUTHOR]

Type II diabetes is a chronic health condition and its successful management requires effective patient-provider communication. Responding to a call to model pathways between provider communication and patient health outcomes, this study tested four models of type II diabetic patient adherence with four mediators. Given the complex nature of type II diabetic care, patient adherence was conceptualized as wellness, screening, medication, and treatment adherence. Mediators included patient understanding, agreement, trust, and motivation. A sample of U.S. patients with type II diabetes patients who were both under the care of a medical provider and taking medication for their type II diabetes completed online surveys (n = 793). Findings indicated that the relationships between patient-centered communication and adherence outcomes were mediated by proximal outcomes. The results contribute to the understanding of patient-centered communication, adherence behaviors, and proximal outcomes of patient understanding, agreement, trust, and motivation. Findings indicate that relationships between patient-centered communication and wellness adherence is mediated by patient motivation, patient-centered communication and screening adherence is mediated by patient agreement, trust, and motivation, and patient-centered communication and treatment adherence is mediated by patient agreement, trust, and motivation. The discussion addresses theoretical and practical implications and directions for future research. [ABSTRACT FROM AUTHOR]

The concept of trust has been extensively studied within the field of medicine. Yet, a list of factors that clearly influence patients' trust is still under debate. Moreover, the methodological approaches found in literature have been reported to be lacking in their assessments and measurements of trust relationships in the medical field although trust between a patient and medical provider has been proven to increase adherence and improve health outcomes. Hence, adding data to this debate and exploring a reliable method to explore the construct of trust is relevant. This study collects new evidence of the most salient indicators of patient trust by using a narrative approach and highlighting the potential of this method in collecting indicators that could be used to build training that aims to increase patients' trust. We used the Linguistic Inquiry and Word Count software for text analysis to examine the spontaneous narrations of episodes of trust and distrust within the doctor-patient relationship with a sample of 82 adult patients. Results demonstrate the role of the emotional aspects of the doctor-patient relationship. Data highlights the importance of doctors' benevolence toward patients, and positive emotions seem to be deeply connected with any experience of trust, which leads patients to feel more secure. Methods are presented to use these insights to construct mechanisms that establish medical trust and allow providers to implement effective interventions. [ABSTRACT FROM AUTHOR]

As the United States' population grows via migration and immigration, with this rise in diverse identities, there has been increasing concern regarding disparities for undocumented immigrants living in the U.S. with limited access to the health system. Given the various constraints involving communication and social structures that undocumented immigrants face, a culture-centered approach is drawn on to investigating how this group goes about navigating a dominant health system given their restricted access. I explore co-constructed themes that emerged through conversations with undocumented immigrants, (people without papers as I call them in this work) living in the United States to gain an understanding as to the structural and cultural limitations faced by this group. By doing qualitative semi-structured interviews with local participants living in the South Florida region, I describe the various features of a complex U.S. health system that undocumented immigrants (people without papers) deemed as important obstacles that limit their willingness to interact with official medical spaces. This work draws on narratives and accounts to shed light on the intersection of disparities this group has to overcome in order to consider entering a medical space to receive the treatment they might need. The findings of this article highlighted the structural violence that certain subaltern groups, such as people without papers experience due to their limited access to foundational systems in their environment. [ABSTRACT FROM AUTHOR]

Public and private decision-making on health problems relies on scientific evidence. However, scientific knowledge includes uncertainty, as does knowledge about COVID-19. In an experimental study, we tested how the trustworthiness (on the three dimensions expertise, integrity, and benevolence) of a source of information (either a scientist or a politician), was affected when messages were either two-sided (including arguments pro and contra the effectiveness of mask-wearing) or one-sided (only pro arguments). Results showed that scientists were ascribed more expertise and integrity compared to politicians, and both sources were ascribed more expertise when they gave two-sided (instead of one-sided) information. Moreover, trustworthiness ratings on all three dimensions were affected by participants' prior topic attitudes and epistemic certainty beliefs. These findings underline that when a source provides two-sided information, this may increase people's willingness to trust that source. To use this strategy most effectively in health communication, more research should be done on how many and what types of counterarguments to include. [ABSTRACT FROM AUTHOR]

This study examines whether social media exposure is associated with the public's beliefs and misbeliefs about human papillomavirus (HPV) vaccination and how those (mis)beliefs are associated with the public's support for HPV vaccination-related policies. This study also explores whether trust in HPV vaccination-related regulatory organizations moderates the associations between social media exposure and public policy support through (mis)beliefs. We found that social media exposure was positively associated with misbeliefs about HPV vaccination. The findings also indicated that while beliefs about benefits were positively associated with policy support for HPV vaccination, misbeliefs were negatively associated with this support. More interestingly, our analysis revealed that the negative association of HPV-related misbeliefs with vaccination policy support was larger for those who had low levels of trust, compared to their high-trust counterparts. [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]

Communication is critical in a new health emergency because it motivates the public to take preventive actions. Prior research has shown that strategies including source credibility, information transparency and uncertainty reduction actions could enhance trust in health communication on social media. Yet research on how the government in China used these trust-building strategies to engage the public during the outbreak of COVID-19 is limited. Therefore, our exploratory study developed an integrated framework for conducting quantitative content analysis to examine how the most popular government-owned newspaper in China, People's Daily, utilized a major social media platform, to engage the public. Our findings showed that accessibility to external links, provision of emotional support, and information on skills and resources were associated with increased public engagement with government COVID-19 posts. Insights gained can enable public health organizations and governments to focus on specific strategies to enhance public engagement. [ABSTRACT FROM AUTHOR]

Black women's health is in a state of crisis. Though Black women make up roughly 12% of the US population, they account for 66% of new HIV cases. One understudied barrier to Black women's sexual health is their communication about the topic of HIV with others and proclivity to dismiss HIV-related information based on self-exemption. Using a group-centered approach called the "sistah circle," this study examines group gatherings of Black women to assess their communication about HIV and determine potential gaps in their understanding of information and HIV-related behavior. Data were derived from five focus groups, with four Black women in each group engaging in a facilitated discussion. Findings from the project extend knowledge about how socializing agents such as school, parents, church, and interventionists have the potential to delay or deter Black women from engaging in communication that supports risk-reducing behaviors and prevention efforts. [ABSTRACT FROM AUTHOR]

Endometriosis is a chronic and often painful inflammatory disease affecting one in ten biological females. It has been characterized as enigmatic and the average diagnostic delay is nearly seven years, time which patients experience as tumultuous and uncertain. This paper presents responses to a final open comment question of a large-scale survey documenting patients' experiences with (mis)diagnosis and highlights how patients perceived healthcare providers (HCPs) as barriers and facilitators to care. Drawing on a framework of trust, we observed that most participants, when discussing HCP-related barriers, raised concerns about HCPs' lack of technical competence, insufficient knowledge about endometriosis and inadequate medical training, followed by concerns about fidelity in which patients recounted experiences of their symptoms being trivialized or dismissed. Respondents also described a causal relationship between competence and fidelity, whereby a lack of competence was perceived to lead HCPs to be dismissive or neglectful. Respondents underscored how patient self-advocacy efforts and online patient communities helped them manage mistrust with HCPs. Although less frequently described, respondents also highlighted the value of HCPs as facilitators to care that similarly emphasized these two dimensions of trust and their inter-connectedness. We discuss the importance of HCPs in shaping patients' care experiences and, in particular, the value of trust for patients with endometriosis and likely other patient populations who seek legitimacy from the medical community but often feel unheard. [ABSTRACT FROM AUTHOR]

The purpose of this study is to explore the process through which institutional trust influences individuals' vaccination intentions for a coronavirus vaccine. We collected data from a national representative sample of the Spanish population (N = 500) from an online research panel to test the proposed conceptual model. Results revealed a positive association of institutional trust with coronavirus vaccination intentions. This effect was mediated by perceived vaccine safety and positive attitude toward the vaccine. Furthermore, findings corroborate the moderating effect of interdependent self-construal on the indirect relationship between institutional trust and vaccination intention, implying that this effect was stronger for individuals with higher levels of interdependent orientation. Findings have implications for the development of evidence-based health communication strategies for encouraging COVID-19 vaccination. [ABSTRACT FROM AUTHOR]

Physicians in residency training experience high levels of medical uncertainty, yet they are often hesitant to discuss uncertainty with parents. Guided by the theory of motivated information management and a multiple goals perspective, this mixed-methods longitudinal study examines associations among residents' tolerance of and reactions to uncertainty, efficacy communicating about uncertainty, and perceptions of parents' trust in them as physicians. To contextualize these associations, we also examined residents' task, identity, and relational goals when communicating about uncertainty with parents. We surveyed 47 pediatric residents at the beginning of each year of their residency program. As they progressed through their training, residents' uncertainty-related anxiety and reluctance to communicate uncertainty to parents decreased, and their efficacy communicating uncertainty with parents increased. Residents' concerns about bad outcomes remained unchanged. Residents pursued multiple, often conflicting, conversational goals when communicating uncertainty with parents. Results reveal important considerations for addressing how residents can manage their uncertainty in productive ways. [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]

Challenges and barriers arise when people communicate interculturally. The situations become more complicated when patients and health professionals from different cultural backgrounds communicate with each other on the sensitive topic of sexual health. This study conducted a systematic review of past literature to identify challenges and perspectives in the intercultural communication between patients and health professionals on the topic of sexual health. The results indicate the research trends and themes generated from narrative data. Language barriers, gender, and privacy concerns of sexual health information present significant challenges in the intercultural communication between patients with immigration backgrounds and health professionals. The perspectives of patients and professionals are included in the research paper. [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]

Public health/risk communication is the foremost responsibility of a government during a pandemic. Risk communication aims to educate people, enhance their risk perceptions to help them engage and understand the benefits of compliance with recommendations. The existing legal enforcement of recommendations in India is criticized for failing to influence the public's compliance. While existing research provides conceptual and empirical support in explaining compliance during COVID-19, we note a lack of studies that might bring out country-specific areas of improvement. We argue that value-aligned risk communication is more likely to influence the public's behavioral intentions to adopt the government's recommendations. We employed a triangulation mixed-method study to link risk communication attributes to the public's end goals and values. We triangulate these findings using the COVID score survey. We found that timeliness and transparency constitute risk communication's functional component, and empathy and trust constitute risk communication's emotional component. We found a difference in the preference of functional and emotional components among the public and health partners. Irrespective of this divide in perception, the study found that both groups unanimously noted engagement as the crucial aspect for empowerment and involvement to aid the public in teaming with the government to combat the pandemic effectively. [ABSTRACT FROM AUTHOR]

Online health reviews are powerful since people use them to glean information about medical professionals. Nonetheless, less is known about what strategies can cultivate positive relationships with consumers when the latter are exposed to patient reviews. A 2 (review valence: negative vs. positive) x 3 (message interactivity: low vs medium vs high) x 2 (review responding source: customer service representative vs. dentist) between-subjects (N = 410) online experiment was conducted. The results showed that positive reviews (vs. negative reviews) and increased organizational responsiveness led to more favorable prospective patient reactions toward the reviewed dental practice. Most importantly, this study detected a significant two-way interaction between review valence and message interactivity. As found, even in the presence of negative reviews higher levels of message interactivity on online review sites can significantly improve the health organization-public relationship (e.g., trust, commitment, satisfaction, control mutuality) as well as enhance organizational reputation and patient behavioral intentions. Mediation tests revealed that source credibility mediated the effects of the review responding source on the relational outcomes, organizational reputation, and consumer behavioral intentions. More specifically, when a dentist replied to the reviews prospective patients perceived favorably the dental clinic and were more likely to visit it in the future than when a customer service representative responded. Theoretical and practical implications for effective online relationship management in the healthcare industry 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]