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Introduction: In the USA, syringe services programmes (SSPs) provide a range of harm reduction services and have numerous benefits for communities. However, stigma, misconceptions about SSPs and changing policies/legislation remain a challenge to effective implementation. This study reviews the implementation of two digital interventions, Appalachian Influence and Shared Influence, which used social media influencers and digital volunteers to communicate positive information about harm reduction and SSPs. Methods: The intervention was designed to deliver accurate and supportive messaging in locally relevant and meaningful ways. Messaging was informed by interviews with subject matter experts and community organisations, and was integrated into prompts used by local influencers (paid individuals with more than 1,000 followers) and digital volunteers (unpaid individuals with no following requirement, who joined the project independently). Results: In the first 6 months of implementation, Appalachian Influence and Shared Influence engaged a total of 9,014 individuals, 236 of whom were paid influencers and 8,778 of whom were digital volunteers. Paid influencer posts achieved a total of 868,943 impressions, 42,432 engagements and 1,567 comments. Comments on paid influencer posts were overwhelmingly positive, with 87.4% positive and 0.8% negative. Interviews showed the importance of understanding local realities, leading with compassion and emphasising the 'human' aspects of dependency and addiction in messaging. Conclusion: This study shows the potential to implement an influencer-led social media intervention to reach people with authentic and compassionate messaging about harm reduction and SSPs. Future research should examine intervention effectiveness and how this approach can be applied to other stigmatised topics.

Introduction: Opioid use disorder (OUD) is a critical health issue in the USA. Pennsylvania has the third highest number of drug overdose deaths per year, with the COVID-19 pandemic worsening these trends. Stigmatising beliefs towards OUD are associated with negative health outcomes, and there is a need for a larger evidence base on OUD stigma reduction strategies. This study reports on the creation and implementation of "Life Unites Us," a digital media campaign which uses a collective impact framework to address OUD stigma reduction across Pennsylvania. Method: "Life Unites Us" consists of various components, including a general public media campaign which uses education and contact-based strategies; engagement with stakeholders and advocates in community-based organisations across the state; and a data sharing website to inform the public of previously unavailable OUD stigma statistics. Each campaign component contributes to the overall collective impact framework. Results: Digital metrics showed 755 followers across the "Life Unites Us" social media pages, and 2,826 total website users with an average of 565 users per month. The campaign has partnered with 60 community based organisations, 921 individuals receive the monthly email and 11 influencers have posted 23 times and achieved over 13,000 engagements and a reach of 661,000. The campaign hosted 5 webinars with 520 attendees and an overall 64.1% attendance rate. Conclusion: This study fills a gap in the need for evidence-based digital interventions to address OUD-related stigma. The positive process metrics from the first 6 months suggest that this model may be an important addition to research on approaches to reduce OUD stigma.

Introduction: In Onondaga County, New York, around half of all births to Black and Hispanic teenage girls are unintended. The Layla's Got You campaign consists of a chatbot and social media campaign designed to increase contraception knowledge among 16- to 25-year-old Black and Hispanic women in Onondaga County. Methods: The campaign was co-created with local women in the target audience and employed digital and grassroots community building strategies. Focus groups were conducted among 31 women, during which participants selected the campaign's logo and chatbot name and created the tagline. Participants reviewed chatbot responses and designed Layla's appearance and features, and Black/Hispanic women are featured in website and promotional photos. A community campaign manager pairs digital strategies with grassroots partnerships among a diverse group of stakeholders, including social media influencers, hair salons and health clinics. Results: Since implementation, the chatbot has received 4,390 messages related to contraception or sexual health. Across social media accounts, the campaign has showed 2,483,683 impressions, average daily reach of 1,710 for Facebook and 943 for Instagram, and 32,816 total engagements across all platforms. Conclusion: Layla's Got You provides young women with a confidential place in which to find locally tailored and trustworthy information about contraception. By merging innovative technology-driven strategies, participatory creation techniques and grassroots community building, the initiative delivers impactful, easily updated health information on a large scale. This strategy has promising implications for increasing knowledge and positive attitudes towards contraception among specific at-risk audiences.

Large-scale digital flu vaccine campaigns have experienced difficulty increasing vaccination coverage among African Americans and Hispanics, and are routinely inundated by negative responses from vaccine opponents. A digital campaign employing user-generated content from social media 'micro' influencers who are predominantly followed by African Americans and Hispanics was implemented during the 2018-19 and 2019-20 flu seasons to disseminate positive information about the flu vaccine. At the time, this constituted the largest influencer-driven health campaign focused on these communities in the United States. Comments on posts were qualitatively coded to determine content perceptions among those exposed to posts. Digital metrics were also analyzed. During Year 1, posts reached 9 million+ social media users and generated 64 612 likes or shares, and 1512 responses. In Year 2, posts reached 8 million+ users and generated 155 600 likes or shares, and 3122 responses. Around 94% of public responses to posts were positive, suggesting this is a promising strategy to communicate health information and could shift social norms, particularly for heavily debated topics such as vaccination. This strategy represents a more community-led and participatory approach than most large-scale vaccination campaigns have attempted, with immediate applicability to communications about the COVID-19 vaccine.

Objective Low birthweight is one of the main causes of poor health outcomes among newborns, with Black women having a disproportionately high prevalence. A digital intervention targeted Black women in Orange County, Florida with information on positive pregnancy-related knowledge and attitudes related to low birthweight. This paper reports on campaign methods for the first 2.5 years of implementation. Methods Campaign content was tailored toward Black women, around a reproductive empowerment lens. Content focused on emphasizing healthy pregnancy-related behaviors and creating positive representations of Black women throughout the various stages of pregnancy through both static images and a web series. Digital metrics gauged campaign engagement. Three cross-sectional online surveys conducted in the intervention county examined Black women's pregnancy-related knowledge, attitudes, and behaviors. Results After two years of campaign implementation, social media accounts showed 1784 followers. While Facebook showed more average monthly impressions, Instagram showed more average monthly engagements. Survey results showed some increases in knowledge about prenatal care, weight gain, exercise, and the health impacts of low birthweight. Conclusions for Practice This study highlights the potential for a culturally-appropriate digital intervention to promote positive pregnancy outcomes among at-risk women. Digital interventions offer a potential way to achieve positive pregnancy-related behavior changes on a larger scale. This may be particularly important given that the COVID-19 pandemic may be changing the ways that pregnant women access information. Studies should examine the impact and feasibility of using culturally-appropriate digital interventions that directly address Black women and their specific experiences during pregnancy., Author(s): Erika Bonnevie [sup.1] , Sarah D. Rosenberg [sup.1] , Jaclyn Goldbarg [sup.1] , Atalie Ashley-West [sup.2] , Joe Smyser [sup.1] Author Affiliations: (1) The Public Good Projects, , 33 [...]

Background: Low birthweight is a health issue disproportionately experienced by Black women. In Hillsborough County, Florida, Black women experience higher rates of low birthweight compared to the rest of Florida. This study examines the feasibility of a second attempt to use a digital low birthweight campaign to increase knowledge about low birthweight and pregnancy among Black women in Hillsborough. Methods: Content for the Growing and Glowing campaign was delivered on social media through a web series with local prenatal care providers and educational images. Two cross-sectional surveys examined changes in pregnancy-related knowledge, attitudes, and behaviors among Black women in Hillsborough. Digital metrics showed campaign reach and engagement. Results: Growing and Glowing attained 1,234 followers, 805,437 impressions, and a reach of 19,875. Web series videos were viewed almost 27,000 times, with 89% average viewer retention. The website attracted 2,634 unique page views. Evaluation surveys showed significant improvements in positive pregnancy-related intentions. Women aware of the campaign showed significantly higher awareness of the importance of prenatal care, and higher awareness of local resources. Conclusion: Results from the second study of this campaign approach suggest that using a highly targeted digital intervention can be a well-received and potentially effective way to deliver pregnancy-related health information to Black women, even during a global pandemic. This approach has numerous benefits in reaching women who may fall outside traditional health marketing approaches. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionsOpioid-related stigma can affect the health and recovery of individuals with opioid use disorder (OUD). As such, campaigns to reduce stigma are needed. We evaluated Life Unites Us (LUU), a comprehensive social media campaign to reduce public stigma of opioids and those who use them, 12 months after campaign launch.A cross-sectional web survey of 1,045 people was used to assess differences in public stigma by exposure to LUU. Survey items focused on public OUD stigma and were divided into three subscales: desire for social distance, treatment availability and effectiveness, and general attitudes.Controlling for relevant covariates (i.e. gender, political ideology, education level, race), individuals exposed to LUU endorsed less stigma in the desire for social distance and treatment subscales. There were no significant differences in stigma for the general attitudes subscale. Those who identified as more politically conservative held more stigma across all subscales than those who identified as less politically conservative. Females reported less treatment and general OUD stigma than males.Findings suggest that comprehensive social media campaigns that foster connections, educate the public, and advocate for community-level change may positively influence public attitudes toward individuals with OUD and create a more supportive environment for recovery. [ABSTRACT FROM AUTHOR]

Abstract Objective: This study evaluates Drunken Rewind, an animated digital media campaign designed to reduce binge drinking. Participants: The campaign was targeted to white males aged 18–34, who are at the highest risk of binge drinking. Methods: The intervention consisted of an animated series that merged health communications approaches with marketing strategies to disseminate health messages. Digital metrics and comments were analyzed to assess receptivity toward the intervention. Results: The series amassed over 900,000 views and 1,762 followers across four social media platforms. Viewer retention rate was between 67%–73% over three seasons; 68.3% of comments on the videos were positive. Conclusions: This study adds evidence that a digital intervention aimed at reducing binge drinking can be feasibly implemented and positively received by a population that is difficult to reach with health messaging. This approach may be useful when applied to other health issues young adults perceive to have lower risk. [ABSTRACT FROM AUTHOR]

Objectives: To report on vaccine opposition and misinformation promoted on Twitter, highlighting Twitter accounts that drive conversation., Methods: We used supervised machine learning to code all Twitter posts. We first identified codes and themes manually by using a grounded theoretical approach and then applied them to the full data set algorithmically. We identified the top 50 authors month-over-month to determine influential sources of information related to vaccine opposition., Results: The data collection period was June 1 to December 1, 2019, resulting in 356 594 mentions of vaccine opposition. A total of 129 Twitter authors met the qualification of a top author in at least 1 month. Top authors were responsible for 59.5% of vaccine-opposition messages. We identified 10 conversation themes. Themes were similarly distributed across top authors and all other authors mentioning vaccine opposition. Top authors appeared to be highly coordinated in their promotion of misinformation within themes., Conclusions: Public health has struggled to respond to vaccine misinformation. Results indicate that sources of vaccine misinformation are not as heterogeneous or distributed as it may first appear given the volume of messages. There are identifiable upstream sources of misinformation, which may aid in countermessaging and public health surveillance.