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BackgroundEffective risk communication about the outbreak of a newly emerging infectious disease in the early stage is critical for managing public anxiety and promoting behavioral compliance. China has experienced the unprecedented epidemic of the coronavirus disease (COVID-19) in an era when social media has fundamentally transformed information production and consumption patterns. ObjectiveThis study examined public engagement and government responsiveness in the communications about COVID-19 during the early epidemic stage based on an analysis of data from Sina Weibo, a major social media platform in China. MethodsWeibo data relevant to COVID-19 from December 1, 2019, to January 31, 2020, were retrieved. Engagement data (likes, comments, shares, and followers) of posts from government agency accounts were extracted to evaluate public engagement with government posts online. Content analyses were conducted for a random subset of 644 posts from personal accounts of individuals, and 273 posts from 10 relatively more active government agency accounts and the National Health Commission of China to identify major thematic contents in online discussions. Latent class analysis further explored main content patterns, and chi-square for trend examined how proportions of main content patterns changed by time within the study time frame. ResultsThe public response to COVID-19 seemed to follow the spread of the disease and government actions but was earlier for Weibo than the government. Online users generally had low engagement with posts relevant to COVID-19 from government agency accounts. The common content patterns identified in personal and government posts included sharing epidemic situations; general knowledge of the new disease; and policies, guidelines, and official actions. However, personal posts were more likely to show empathy to affected people (χ21=13.3, P

BackgroundSeasonal influenza vaccination (SIV) coverage among young children remains low worldwide. Mobile social networking apps such as WhatsApp Messenger are promising tools for health interventions. ObjectiveThis was a preliminary study to test the effectiveness and parental acceptability of a social networking intervention that sends weekly vaccination reminders and encourages exchange of SIV-related views and experiences among mothers via WhatsApp discussion groups for promoting childhood SIV. The second objective was to examine the effect of introducing time pressure on mothers’ decision making for childhood SIV for vaccination decision making. This was done using countdowns of the recommended vaccination timing. MethodsMothers of child(ren) aged 6 to 72 months were randomly allocated to control or to one of two social networking intervention groups receiving vaccination reminders with (SNI+TP) or without (SNI–TP) a time pressure component via WhatsApp discussion groups at a ratio of 5:2:2. All participants first completed a baseline assessment. Both the SNI–TP and SNI+TP groups subsequently received weekly vaccination reminders from October to December 2017 and participated in WhatsApp discussions about SIV moderated by a health professional. All participants completed a follow-up assessment from April to May 2018. ResultsA total of 84.9% (174/205), 71% (57/80), and 75% (60/80) who were allocated to the control, SNI–TP, and SNI+TP groups, respectively, completed the outcome assessment. The social networking intervention significantly promoted mothers’ self-efficacy for taking children for SIV (SNI–TP: odds ratio [OR] 2.69 [1.07-6.79]; SNI+TP: OR 2.50 [1.13-5.55]), but did not result in significantly improved children’s SIV uptake. Moreover, after adjusting for mothers’ working status, introducing additional time pressure reduced the overall SIV uptake in children of working mothers (OR 0.27 [0.10-0.77]) but significantly increased the SIV uptake among children of mothers without a full-time job (OR 6.53 [1.87-22.82]). Most participants’ WhatsApp posts were about sharing experience or views (226/434, 52.1%) of which 44.7% (101/226) were categorized as negative, such as their concerns over vaccine safety, side effects and effectiveness. Although participants shared predominantly negative experience or views about SIV at the beginning of the discussion, the moderator was able to encourage the discussion of more positive experience or views and more knowledge and information. Most intervention group participants indicated willingness to receive the same interventions (110/117, 94.0%) and recommend the interventions to other mothers (102/117, 87.2%) in future ConclusionsOnline information support can effectively promote mothers’ self-efficacy for taking children for SIV but alone it may not sufficient to address maternal concerns over SIV to achieve a positive vaccination decision. However, the active involvement of health professionals in online discussions can shape positive discussions about vaccination. Time pressure on decision making interacts with maternal work status, facilitating vaccination uptake among mothers who may have more free time, but having the opposite effect among busier working mothers. Trial RegistrationHong Kong University Clinical Trials Registry HKUCTR-2250; https://tinyurl.com/vejv276

The coronavirus disease (COVID-19) pandemic disproportionally affects socially disadvantaged populations because of economic, social, and demographic factors, as well as their health conditions and practices (1). Identifying vulnerable communities and [...]

Introduction: This prospective, single‐arm, pragmatic implementation study evaluated the feasibility of a nurse‐led symptom‐screening program embedded in routine oncology post‐treatment outpatient clinics by assessing (1) the acceptance rate for symptom distress screening (SDS), (2) the prevalence of SDS cases, (3) the acceptance rate for community‐based psychosocial support services, and (4) the effect of referred psychosocial support services on reducing symptom distress. Methods: Using the modified Edmonton Symptom Assessment System (ESAS‐r), we screened patients who recently completed cancer treatment. Patients screening positive for moderate‐to‐severe symptom distress were referred to a nurse‐led community‐based symptom‐management program involving stepped‐care symptom/psychosocial management interventions using a pre‐defined triage system. Reassessments were conducted at 3‐months and 9‐months thereafter. The primary outcomes included SDS acceptance rate, SDS case prevalence, intervention acceptance rate, and ESAS‐r score change over time. Results: Overall, 2988/3742(80%) eligible patients consented to SDS, with 970(32%) reporting ≥1 ESAS‐r symptom as moderate‐to‐severe (caseness). All cases received psychoeducational material, 673/970(69%) accepted psychosocial support service referrals. Among 328 patients completing both reassessments, ESAS‐r scores improved significantly over time (p < 0.0001); 101(30.8%) of patients remained ESAS cases throughout the study, 112(34.1%) recovered at 3‐month post‐baseline, an additional 72(22%) recovered at 9‐month post‐baseline, while 43(12.2%) had resumed ESAS caseness at 9‐month post‐baseline. Conclusion: Nurse‐led SDS programs with well‐structured referral pathways to community‐based services and continued monitoring are feasible and acceptable in cancer patients and may help in reducing symptom distress. We intend next to develop optimal strategies for SDS implementation and referral within routine cancer care services. [ABSTRACT FROM AUTHOR]