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Dialogue with people who are vaccine hesitant has been recommended as a method to increase vaccination uptake. The process of cultivating dialogue is shaped by the context in which it occurs, yet the development of interventions addressing vaccine hesitancy with dialogue often overlooks the role of context and favors relatively fixed solutions. This reflexive paper shares three key lessons related to context for dialogue-based interventions. These lessons emerged during a participatory research project to develop a pilot intervention to create open dialogue among healthcare workers in Belgium about COVID-19 vaccination concerns. Through a mixed methods study consisting of in-depth interviews, focus group discussions, and surveys, we engaged healthcare workers in the design, testing, and evaluation of a digital platform featuring text-based and video-based (face-to-face) interactions. The lessons are: (1) what dialogue means, entails, and requires can vary for a population and context, (2) inherent tension exists between helping participants voice (and overcome) their concerns and exposing them to others' ideas that may exacerbate those concerns, and (3) interactional exchanges (e.g., with peers or experts) that matter to participants may shape the dialogue in terms of its content and form. We suggest that having a discovery-orientation—meaning to work not only inductively and iteratively but also reflexively—is a necessary part of the development of dialogue-based interventions. Our case also sheds light on the influences between: dialogue topic/content, socio-political landscape, population, intervention aim, dialogue form, ethics, researcher position, and types of interactional exchanges.

Background In this era of global health crises, public trust in scientists is a crucial determinant of adherence to public health recommendations. Studies of trust in scientists often link sociodemographic and other factors to such adherence but rely on assumptions about scientists and neglect scientific uncertainty. We undertook a cross-sectional mixed-methods study evaluating factors associated with public trust of scientists in Europe, investigating how and why respondents embraced certain claims in scientific debates.Methods A survey was administered to 7000 participants across seven European countries in December 2020. Data concerning sociodemographic characteristics, trust in scientists, information source preferences, COVID-19 experiences and beliefs about pandemic origins were analysed using a multiple regression model. We employed thematic analysis to interpret open-text responses about pandemic origins and likely acceptance of treatments and vaccination.Results Trust in scientists was associated with multiple sociodemographic characteristics, including higher age and educational levels, left/centre political affiliation and use of certain information sources. Respondents claiming that COVID-19 was deliberately released and that 5G technology worsened COVID-19 symptoms had lower levels of trust in scientists. Explaining their positions in debates about pandemic origins, respondents trusting and not trusting scientists invoked scientific results and practices, arguing that scientists were not the most important actors in these debates.Conclusions Although our quantitative analyses align with prior studies, our qualitative analyses of scientists, their practices and perceived roles are more varied than prior research presumed. Further investigation of these variations is needed to strengthen scientific literacy and trust in scientists.

BackgroundThe COVID-19 pandemic has been widely described as an infodemic, an excess of rapidly circulating information in social and traditional media in which some information may be erroneous, contradictory, or inaccurate. One key theme cutting across many infodemic analyses is that it stymies users’ capacities to identify appropriate information and guidelines, encourages them to take inappropriate or even harmful actions, and should be managed through multiple transdisciplinary approaches. Yet, investigations demonstrating how the COVID-19 information ecosystem influences complex public decision making and behavior offline are relatively few. ObjectiveThe aim of this study was to investigate whether information reported through the social media channel Twitter, linked articles and websites, and selected traditional media affected the risk perception, engagement in field activities, and protective behaviors of French Red Cross (FRC) volunteers and health workers in the Paris region of France from June to October 2020. MethodsWe used a hybrid approach that blended online and offline data. We tracked daily Twitter discussions and selected traditional media in France for 7 months, qualitatively evaluating COVID-19 claims and debates about nonpharmaceutical protective measures. We conducted 24 semistructured interviews with FRC workers and volunteers. ResultsSocial and traditional media debates about viral risks and nonpharmaceutical interventions fanned anxieties among FRC volunteers and workers. Decisions to continue conducting FRC field activities and daily protective practices were also influenced by other factors unrelated to the infodemic: familial and social obligations, gender expectations, financial pressures, FRC rules and communications, state regulations, and relationships with coworkers. Some respondents developed strategies for “tuning out” social and traditional media. ConclusionsThis study suggests that during the COVID-19 pandemic, the information ecosystem may be just one among multiple influences on one group’s offline perceptions and behavior. Measures to address users who have disengaged from online sources of health information and who rely on social relationships to obtain information are needed. Tuning out can potentially lead to less informed decision making, leading to worse health outcomes.

Introduction Voluntary organisations provide essential support to vulnerable populations and front-line health responders to the COVID-19 pandemic. The French Red Cross (FRC) is prominent among organisations offering health and support services in the current crisis. Comprised primarily of lay volunteers and some trained health workers, FRC volunteers in the Paris (France) region have faced challenges in adapting to pandemic conditions, working with sick and vulnerable populations, managing limited resources and coping with high demand for their services. Existing studies of volunteers focus on individual, social and organisational determinants of motivation, but attend less to contextual ones. Public health incertitude about the COVID-19 pandemic is an important feature of this pandemic. Whether and how uncertainty interacts with volunteer understandings and experiences of their work and organisational relations to contribute to Red Cross worker motivation is the focus of this investigation.Methods and analysis This mixed-methods study will investigate volunteer motivation using ethnographic methods and social network listening. Semi-structured interviews and observations will illuminate FRC volunteer work relations, experiences and concerns during the pandemic. A questionnaire targeting a sample of Paris region volunteers will allow quantification of motivation. These findings will iteratively shape and be influenced by a social media (Twitter) analysis of biomedical and public health uncertainties and debates around COVID-19. These tweets provide insight into a French lay public’s interpretations of these debates. We evaluate whether and how socio-political conditions and discourses concerning COVID-19 interact with volunteer experiences, working conditions and organisational relations to influence volunteer motivation. Data collection began on 15 June 2020 and will continue until 15 April 2021.Ethics and dissemination The protocol has received ethical approval from the Institut Pasteur Institutional Review Board (no 2020-03). We will disseminate findings through peer-reviewed articles, conference presentations and recommendations to the FRC.