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Background: The Coronavirus disease-2019 (COVID-19) vaccines were rolled out in many countries; however, sub-optimal COVID-19 vaccine uptake remains a major public health concern globally. This study aimed at assessing the factors that affected the uptake, hesitancy, and resistance of the COVID-19 vaccine among university undergraduate students in Malawi, a least developed country in Africa. Methods: A descriptive cross-sectional study design was conducted using an online semi-structured questionnaire. A total of 343 University undergraduate students in Blantyre participated in this study after obtaining ethical clearance. Data was exported from Survey Monkey to Microsoft Excel version-21 for cleaning and was analysed using SPSS version-29. Descriptive statistics, including percentages, were performed to define the sample characteristics. Pearson Chi-square and Fisher's exact test were performed to identify significant relationships between vaccine uptake and demographics. A 95% confidence interval was set, and a p-value of < 0.05 was considered statistically significant. Results: Of the 343 participants, 43% were vaccinated. Among the vaccinated, the majority (47.3%, n = 69/146) received Johnson & Johnson vaccine followed by AstraZeneca (46.6%, n = 68/146). The commonly reported reason for vaccine acceptance was 'to protect me against getting COVID-19' (49%); whereas vaccine hesitancy was attributed to 'lack of knowledge (34%), and concerns about vaccine safety (25%). Conclusions: This study found that adequate knowledge about benefits and safety of COVID-19 vaccine could potentially increase uptake. Lack of credible information or misinformation contributed to vaccine hesitancy. The findings provide insights for design of strategies to increase future vaccine uptake and reduce determinants of vaccine hesitancy. To reduce vaccination hesitancy in any population with or without higher education, we recommend that institutions entrusted with vaccine management must optimise health messaging, and reduce mis-information and dis-information. [ABSTRACT FROM AUTHOR]

During extreme heat events (EHEs) the public often learns about health protective actions through the media. Visual news coverage can act as a powerful tool to help convey complex health protective actions to the public. Despite the importance of images in helping the public understand the risk, there has been no systematic analysis to assess what images have been used by media outlets in Canada during EHEs. This paper helps to fill that gap by analyzing how the Canadian media visually communicated the risks of extreme heat to the public during the unprecedented 2021 Heat Dome. A review of thousands of online news media articles published about the 2021 Heat Dome in Canada was conducted on five subscription news databases. Overall, 845 images were coded to identify denotative, connotative, and ideological content. Only 16% of these published images implied that heat was dangerous, of which only 40% depicted people, and 46% implied human suffering. Our findings demonstrate that the majority of images used in Canadian news coverage on the 2021 Heat Dome are incompatible with, and frequently contradict, evidence-based heat protective actions. Governments, public health agencies, and other stakeholders engaged in distributing heat preparedness messaging (e.g., journalists) should prioritize improving the images of extreme heat in news coverage to align with evidence-based public health messages. With rising global temperatures due to climate change and the associated increases in the frequency and intensity of extreme heat events, prioritizing these actions is critically important to offset the threat posed to public health. [ABSTRACT FROM AUTHOR]

BACKGROUND: Youth may be reluctant to seek health care from school health providers due to feeling embarrassed or stigmatized in the health office environment or worried about their confidentiality. The purpose of this project was to create a set of youth‐centered health posters that promote youth engagement with nursing staff and to standardize health messaging across high schools in Hawaii school‐based clinics. METHODS: Two community advisory boards, 1 composed of 10 youth stakeholders (mean age 17 years) and the other of 7 adult stakeholders, informed poster development utilizing web‐based discussion groups. The discussions were transcribed, and additional data was collected using field notes and anonymous digital messages. Adult advisory board members also provided feedback on suggested poster text through an online survey. RESULTS: Youth and adult advisory board participants identified 4 key health concerns facing youth: confidentiality, sexual health, relationships, and mental health. Based on input from the 2 advisory boards, 4 posters were developed, each centered on 1 key health issue. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: School‐based posters can convey important messages to help youth understand their health care rights and responsibilities, as well as identify important issues open for discussion with nurses. CONCLUSION: Posters are an underutilized tool for school health providers to create welcoming, inclusive health care environments and facilitate health‐related conversations with youth. This paper describes participant feedback about the characteristics of a memorable poster and briefly outlines current knowledge and recommendations for school health providers regarding each of the 4 health issues. [ABSTRACT FROM AUTHOR]

The current research examines the interactive effect of consumers' moral identity and risk factor stigma on health message effectiveness. The authors theorize that engaging in advocated health behaviors has moral associations; however, a stigmatized risk factor in a message "taints" the morality of the advocated health behavior. Thus, consumers with high (vs. low) moral identity are more likely to comply with health messages when risk factor stigma is low, and this positive moral identity effect is undermined when risk factor stigma is high. The authors test stigma's threat to moral identity by measuring defensive processing (Studies 1 and 2) and the attenuating effect of self-affirmation on the negative effect of stigma (Studies 3 and 4). They apply the stigma-by-association principle to develop and test a messaging intervention (Study 5). The studies suggest that, depending on whether a health message contains stigmatized risk factors, marketers could employ a combination of tactics such as activating moral identity, offering self-affirming message frames, and/or highlighting low-stigma risk factors to bolster message effectiveness. [ABSTRACT FROM AUTHOR]

IntroductionFor African American women in Houston, cervical cancer mortality is disproportionate to their racial and ethnic counterparts. Most notably, lack of human papillomavirus (HPV) screening and vaccination as well as late diagnosis increase cervical cancer mortality. However, cervical cancer is largely preventable. While previous research has identified a few social determinants that are specifically related to cervical cancer (e.g., education, income, neighborhood), there may be a host of additional social and cultural factors that contribute to a lack of preventative behavior.MethodsThe present study used concept mapping to explore sociocultural determinants of cervical cancer prevention beliefs among young African American women. N = 15 African American women, ages 18–25, participated in a group concept mapping session focused on cervical cancer knowledge, beliefs about women’s health, and how their social environment and culture play a role in their conceptualization of cervical cancer prevention.DiscussionFive overarching concepts emerged: (1) Screening, (2) Support System, (3) Cervical Cancer 101 (knowledge), (4) Fatalism, and (5) Ease of Prevention.ConclusionThe present study highlights the use of concept mapping for prevention science, particularly in exploratory studies for understanding cervical cancer screening barriers, avenues for intervention, and public health messaging. We discuss the findings and implications for public health research in cervical cancer prevention tailored for African American women.

Staying well informed about the evolving COVID-19 pandemic and vaccine recommendations is vital for older adults, especially for low-income older adults, who have been disproportionately impacted by the pandemic. However, the overwhelming infodemic poses a significant challenge, affecting vaccine decision-making. This study explores how a group of predominantly low-income older adults navigate health information and how their trust in information and vaccines evolves throughout the pandemic. Our objective is to provide insights that will guide future public health messaging for this demographic. Analyzing qualitative data from 77 older adults (aged 65 to 94) collected through focus groups and interviews, our findings reveal that participants' experiences with information overload eroded their trust in authority, leading to vaccine hesitancy. Moreover, the need for a booster has affected belief in vaccine safety and efficacy. As participants lost faith in the media and authoritative sources, they increasingly leaned on personal networks for guidance. These results underscore the urgent necessity for clear, unambiguous ongoing vaccine guidance to restore institutional trust among older adults. Additionally, recognizing the influential role of direct networks in vaccine decisions, integrating care workers, service providers, and peer-to-peer support into health messaging mechanisms could prove valuable. [ABSTRACT FROM AUTHOR]

Abstract Background Policy makers need to maintain public trust in healthcare systems in order to foster citizen engagement in recommended behaviors and treatments. The importance of such commitment has been highlighted by the recent COVID-19 pandemic. Central to public trust is the extent of the accountability of health authorities held responsible for long-term effects of past treatments. This paper addresses the topic of manifestations of trust among patients damaged by radiation treatments for ringworm. Methods For this mixed-methods case study (quan/qual), we sampled 600 files of Israeli patients submitting claims to the National Center for Compensation of Scalp Ringworm Victims in the years 1995–2014, following damage from radiation treatments received between 1946 and 1960 in Israel and/or abroad. Qualitative data were analyzed with descriptive statistics, and correlations were analyzed with chi-square tests. Verbal data were analyzed by the use of systematic content analysis. Results Among 527 patients whose files were included in the final analysis, 42% held authorities responsible. Assigning responsibility to authorities was more prevalent among claimants born in Israel than among those born and treated abroad (χ 2 = 6.613, df = 1, p = 0.01), claimants reporting trauma (χ 2 = 4.864, df = 1, p = 0.027), and claimants living in central cities compared with those in suburban areas (χ 2 = 18.859, df = 6, p

This research examines the psychological processes and factors that shape illness-detection versus illness-prevention health actions. Four experiments using contexts of mental health, skin cancer, and breast cancer show that illness detection evokes fear, which undermines engagement in detection behaviors. Considering detection at low (vs. high) levels of thought reduced fear and increased health persuasion. Illness prevention is driven by self-efficacy perceptions and considering prevention at high (vs. low) levels of thought increases persuasion. In further evidence of process, trait fear moderated the detection effects, and dispositional self-efficacy moderated the prevention effects. As an intervention, framing a detection action as serving illness-prevention goals increased people's likelihood of engaging with an online breast cancer detection tool. These findings illuminate the psychology of detection as being distinct from the psychology of prevention, identify the role of fear in the consideration of health behaviors, and show contexts in which construal levels have divergent effects on health persuasion. [ABSTRACT FROM AUTHOR]

Smoking continues to be a major public health problem, despite a substantial decline in prevalence rates over the last decades. Quit smoking interventions typically target smokers, whether through individual or group treatment or through broader public health campaigns. Yet, nonsmokers represent a vast and largely untapped resource to help smokers quit. This article describes an innovative approach that targeted nonsmokers through a media-style campaign with repeated reminders about smoking cessation. We tested the nonsmoker intervention in a large randomized trial and showed it to be effective in helping smokers quit. Components of the intervention included repeated mailings with relevant cessation messages over a 10-week period, 2 brief check-in telephone calls, and access to a study Web site. In this article, we discuss details of the intervention development, content, and implementation.

Background: Policy makers need to maintain public trust in healthcare systems in order to foster citizen engagement in recommended behaviors and treatments. The importance of such commitment has been highlighted by the recent COVID-19 pandemic. Central to public trust is the extent of the accountability of health authorities held responsible for long-term effects of past treatments. This paper addresses the topic of manifestations of trust among patients damaged by radiation treatments for ringworm. Methods: For this mixed-methods case study (quan/qual), we sampled 600 files of Israeli patients submitting claims to the National Center for Compensation of Scalp Ringworm Victims in the years 1995–2014, following damage from radiation treatments received between 1946 and 1960 in Israel and/or abroad. Qualitative data were analyzed with descriptive statistics, and correlations were analyzed with chi-square tests. Verbal data were analyzed by the use of systematic content analysis. Results: Among 527 patients whose files were included in the final analysis, 42% held authorities responsible. Assigning responsibility to authorities was more prevalent among claimants born in Israel than among those born and treated abroad (χ2 = 6.613, df = 1, p = 0.01), claimants reporting trauma (χ2 = 4.864, df = 1, p = 0.027), and claimants living in central cities compared with those in suburban areas (χ2 = 18.859, df = 6, p < 0.01). Men, younger claimants, patients with a psychiatric diagnosis, and patients from minority populations expressed mistrust in health regulators. Conclusions: Examining populations' perceived trust in healthcare institutions and tailoring health messages to vulnerable populations can promote public trust in healthcare systems. [ABSTRACT FROM AUTHOR]

People living with Type 1 and Type 2 diabetes (T1DM &T2DM) report that media – including journalism, health promotion, and popular culture – are a primary source of stigmatic representations of diabetes, and that this compromises their physical and mental health. This view of diabetes as stigmatised is not shared by many health professionals and nor the wider public. We used an existing representation of diabetes on Instagram, #DiabetesOnAPlate, to examine how stigmatic representations of diabetes are (re)produced, discussed, and contested. Our analysis found that, consistent with the notion of diabetes as stigmatised, use of the hashtag #DiabetesOnAPlate on Instagram is associated with public health discourses of indulgent eating and with posts that signal recognition of this as a moral transgression. A subsequent on-line survey found that participants who did not have diabetes did not recognise a prototypical #DiabetesOnAPlate post as stigmatic. Whilst some with T1DM and T2DM did perceive and contest the stigma, T1DM participants did so for their group (but not for T2DM); and there was evidence that some T2DM participants internalised the stigma. These findings support concerns about the everyday, divisive nature of stigmatic representations of diabetes on social network sites, which on the one hand reflect public health discourse and on the other may compromise health policy objectives and exacerbate health inequalities. [ABSTRACT FROM AUTHOR]

Abstract Background Many people do not meet the recommended health guidance of participation in a minimum of 150–300 min of moderate intensity physical activity per week, often promoted as at least 30 min of physical activity on 5 days of the week. This is concerning and highlights the importance of finding innovative ways to help people to be physically active each day. Snacktivity™ is a novel approach that aims to encourage people to do small, 2–5 min bouts of physical activity ‘snacks’ throughout the whole day, such that they achieve at least 150 min of moderate intensity activity per week. However, before it can be recommended, there is a need to explore whether the concept is acceptable to the public. Methods A survey to assess the views of the public about Snacktivity™ was distributed to adult patients registered at six general practices in the West Midlands, UK and to health care employees in the same region. Results A total of 5989 surveys were sent to patients, of which 558 were returned (9.3%). A further 166 surveys were completed by health care employees. A total of 85% of respondents liked the Snacktivity™ concept. The flexibility of the approach was highly rated. A high proportion of participants (61%) reported that the ability to self-monitor their behaviour would help them to do Snacktivity™ throughout their day. Physically inactive participants perceived that Snacktivity™ would help to increase their physical activity, more than those who were physically active (OR = 0.41, 95% CI: 0.25–0.67). Approximately 90% of respondents perceived that Snacktivity™ was easy to do on a non-working day compared to 60% on a working day. Aerobic activity ‘snacks’ were preferred to those which were strength based. Conclusions The Snacktivity™ approach to promoting physical activity was viewed positively by the public and interventions to test the merits of such an approach now need to be developed and tested in a variety of everyday contexts.

• We observed parents with high HPV vaccine hesitancy reported lower intent to have their child receive the COVID-19 vaccine. • Parents that were reluctant to vaccinate their adolescent against COVID-19 had higher HPV vaccine hesitancy. • Improving health messages to reduce overall vaccine hesitancy may be an effective way at addressing vaccination disparities among underrepresented groups. Parental human papillomavirus (HPV) vaccine hesitancy contributes to delays or refusals in adolescent uptake. It is unclear if COVID-19 vaccine hesitancy has further impacted the low HPV vaccine uptake trends among underrepresented minorities. This study examines the relationship between COVID-19 vaccine intent and HPV vaccine hesitancy among parents for their adolescents in communities with low vaccine uptake in Los Angeles County. Parents from a school-based academic enrichment program serving low-income, first-generation immigrant families completed an online cross-sectional survey to understand parental HPV vaccine hesitancy, adolescent HPV vaccine behavior, and attitudes towards other vaccines, including intent to receive COVID-19 vaccines. In March 2021, parents with children ages 9–17 years completed online surveys. Using multivariate logistic regression models, we examined whether low parent intent to vaccinate their adolescent against COVID-19 was associated with hesitancy to vaccinate against HPV. A total of 291 surveys were completed. Among parents with high HPV vaccine hesitancy for their adolescent, 33 % did not intend to vaccinate their adolescent against COVID-19 compared to 7 % among parents with low HPV vaccine hesitancy. Low parent intention to vaccinate adolescent against COVID-19 was associated with higher HPV vaccine hesitancy (p < 0.01) after controlling for parent nativity status, medical mistrust, receiving the flu vaccination and negative HPV information. Our findings indicate associations between low parental COVID-19 vaccine intent and higher HPV vaccine hesitancy for their adolescent. Identifying community-relevant health interventions to address parental vaccine hesitancy across multiple child and adolescent vaccines may help to achieve equitable vaccine uptake. [ABSTRACT FROM AUTHOR]

Staying well informed about the evolving COVID-19 pandemic and vaccine recommendations is vital for older adults, especially for low-income older adults, who have been disproportionately impacted by the pandemic. However, the overwhelming infodemic poses a significant challenge, affecting vaccine decision-making. This study explores how a group of predominantly low-income older adults navigate health information and how their trust in information and vaccines evolves throughout the pandemic. Our objective is to provide insights that will guide future public health messaging for this demographic. Analyzing qualitative data from 77 older adults (aged 65 to 94) collected through focus groups and interviews, our findings reveal that participants’ experiences with information overload eroded their trust in authority, leading to vaccine hesitancy. Moreover, the need for a booster has affected belief in vaccine safety and efficacy. As participants lost faith in the media and authoritative sources, they increasingly leaned on personal networks for guidance. These results underscore the urgent necessity for clear, unambiguous ongoing vaccine guidance to restore institutional trust among older adults. Additionally, recognizing the influential role of direct networks in vaccine decisions, integrating care workers, service providers, and peer-to-peer support into health messaging mechanisms could prove valuable.

Accessing healthcare during a disaster matters for the well-being of people and communities. This article explores healthcare messaging about General Practitioner (GP) services for non-COVID-19 health concerns during the Level 4 lockdown in Te Papaioea (Palmerston North), Aotearoa New Zealand. Messaging from Government, media and local GP clinics were analysed to understand how people were advised to seek care for non-COVID-19 health concerns. We found inconsistencies in these communications, ranging from messages to not attend healthcare services because of possible COVID-19 surges, to messages with vague, or lack of, information. Government messages did include advice for seeking general healthcare, but this was largely rendered invisible due to the focus on ‘staying home, saving lives’. Media messaging was similarly influenced by these Government directives. Few GP clinics had websites, and few provided information about accessing general healthcare services. Clinics also lacked up-to-date telephone messages about seeking healthcare for non-COVID-19 symptoms and illnesses. All three sources neglected the cultural, social and contextual diversity of the local audience. We recommend that communication during disasters should be clear, concise and consistent. Further, GPs should be supported to have websites and telecommunication platforms. All communications should be inclusive and aim to reach diverse audiences.

Alcohol labelling enables people to make informed decisions about the products they purchase and consume. This rapid review explores the impact of health messaging and product information on consumer attention, comprehension, recall, judgment and behavioural compliance in relation to alcohol use. The rapid review adopted a multi-faceted search strategy to identify primary studies on health messaging and/or product information on alcohol packaging, and the impact of these on consumer-related outcomes. The review provides support for large, colourful labels on the front of alcohol products and the use of plain packaging to increase the visibility of health messaging. It also supports the use of explicit, negatively-framed statements that link alcohol to specific diseases. Colour-coded schemes and pictorial warnings may further optimize the effectiveness of alcohol labels. We did not find sufficient evidence to support the effectiveness of product information alone in influencing consumerattention, comprehension, recall, judgment and behavioural compliance. Well-designed alcohol labels can positively influence consumers' attention, comprehension, recall, judgment and behavioural compliance. The findings have implications for alcohol labelling research and policy. [ABSTRACT FROM AUTHOR]

COVID-19 has impacted the lives of many Canadians physically, emotionally, and financially. This commentary focuses on suggestions on how to use social media platforms to target Canadians to promote public COVID-19 related health messaging. Policy strategies that limit the use of algorithms for social media in an effort to eliminate opinion silos and provide users with a more well-rounded view of current events are explored. [ABSTRACT FROM AUTHOR]

Introduction: This article aims to increase understanding of how Mexican immigrants respond to learning about non-alcoholic fatty liver disease (NAFLD), a spectrum disease with a heavy burden among Mexican-origin people. Methodology: This article presents findings from qualitative interviews (n = 26) that formed part of a mixed-methods study of foreign-born Mexican immigrants carried out in 2019 to 2020 in southern Arizona to assess NAFLD awareness. Results: We documented common experiences of surprise, fear, and hope during study participation, all of which motivated research participants to reduce their NAFLD risk by seeking additional information, sharing it with others, and making lifestyle changes. Discussion: Understanding how these emotional experiences are tied to cultural and historical factors—including Mexico's high rates of liver disease, participant's limited access to health care, and the ability to address the NAFLD risk with lifestyle changes—may promote the development of more effective and culturally congruent care in this population. [ABSTRACT FROM AUTHOR]

IntroductionAZCOVIDTXT, a bilingual, two-way information sharing platform was created in April of 2020 in response to rising COVID-19 cases in Arizona. The aim of this paper is to delineate the protocol and processes used to develop and disseminate health messaging to serve as guidance for other groups, universities, or public health programs in the implementation or enhancement of health communication services.MethodsHealth messaging formats included website articles, published on the system's website (azcovidtxt.org), infographics posted on social media, and SMS. Social media and SMS infographics were intended to highlight and augment the topics covered in the weekly website articles, to create a seamless multimodal source of reliable COVID-19 information for AZCOVIDTXT enrollees and the broader public. All health messaging information, text message and social media content was planned and reviewed collaboratively by the AZCOVIDTXT team topic experts for accuracy, efficacy, and content consistency.ResultsAs of July 2021, AZCOVIDTXT provided weekly COVID-19-related health communication to 3,747 participating households located across 225 Arizona zip codes. AZCOVIDTXT has developed and sent 446 unique, bilingual SMS for a total of 271,977 contact points. The team has produced and published 179 website articles, which averaged a combined 7,000-page views per month, and 173 social media posts were made available to 268 followers across three platforms.DiscussionSeveral programmatic aspects were deemed essential to the success of AZCOVIDTXT. These included (1) addressing community specific needs, (2) creating timely and relevant content, (3) developing an adaptable system, and (4) prioritizing system automation where possible, (5) having an interdisciplinary team approach to identifying and crafting key messages.

Within weeks of the World Health Organization declaring the COVID-19 outbreak a global pandemic, domestic violence and sexual assault incidents increased. To adhere to new health protocols, social service providers were encouraged to move outreach efforts to virtual formats. We draw on 21 in-depth interviews with Louisiana organizations working in violence against women to examine how they 1) transitioned to online outreach efforts and 2) adapted their messaging to the COVID-19 context. We found that organizations who successfully moved to virtual efforts credited their success to thinking creatively and properly matching educational activities to digital media platforms, while those who struggled pointed to obstacles such as digital media fatigue and funding limitations (RQ1). We also identified three changes to message framing (RQ2): 1) Empathy and reassurance, especially, reiterating that centers "are there" for victims 2) Addressing racial justice issues, and 3) describing COVID-19 protocols and conducting lockdown-focused education efforts. [ABSTRACT FROM AUTHOR]

Uncertainty, fear, and distress have become prevalent in the lives of U.S. residents since the beginning of the COVID-19 pandemic. The unpredictable reality of social distancing, shutdowns, and isolation have affected daily routines and influenced well-being and health. Drawing on consumer culture theory, we conducted an exploratory study to examine the mediating role of consumer spirituality in the subjective well-being of religious Christians during COVID-19 and to discover links between well-being and health outcomes. Participants from the United States (n = 104) were recruited via a Qualtrics' online panel. Findings show that religiosity among Christians enhanced subjective well-being, demonstrating the positive effect of religious beliefs, especially during the COVID-19 pandemic. However, spiritual consumption mediated this relationship, suggesting the importance of possessions to religious expression and subjective well-being. Implications for messaging about health and well-being are discussed. [ABSTRACT FROM AUTHOR]

Background: Many people do not meet the recommended health guidance of participation in a minimum of 150-300 min of moderate intensity physical activity per week, often promoted as at least 30 min of physical activity on 5 days of the week. This is concerning and highlights the importance of finding innovative ways to help people to be physically active each day. Snacktivity™ is a novel approach that aims to encourage people to do small, 2-5 min bouts of physical activity 'snacks' throughout the whole day, such that they achieve at least 150 min of moderate intensity activity per week. However, before it can be recommended, there is a need to explore whether the concept is acceptable to the public.Methods: A survey to assess the views of the public about Snacktivity™ was distributed to adult patients registered at six general practices in the West Midlands, UK and to health care employees in the same region.Results: A total of 5989 surveys were sent to patients, of which 558 were returned (9.3%). A further 166 surveys were completed by health care employees. A total of 85% of respondents liked the Snacktivity™ concept. The flexibility of the approach was highly rated. A high proportion of participants (61%) reported that the ability to self-monitor their behaviour would help them to do Snacktivity™ throughout their day. Physically inactive participants perceived that Snacktivity™ would help to increase their physical activity, more than those who were physically active (OR = 0.41, 95% CI: 0.25-0.67). Approximately 90% of respondents perceived that Snacktivity™ was easy to do on a non-working day compared to 60% on a working day. Aerobic activity 'snacks' were preferred to those which were strength based.Conclusions: The Snacktivity™ approach to promoting physical activity was viewed positively by the public and interventions to test the merits of such an approach now need to be developed and tested in a variety of everyday contexts. [ABSTRACT FROM AUTHOR]

Accessing healthcare during a disaster matters for the well-being of people and communities. This article explores healthcare messaging about General Practitioner (GP) services for non-COVID-19 health concerns during the Level 4 lockdown in Te Papaioea (Palmerston North), Aotearoa New Zealand. Messaging from Government, media and local GP clinics were analysed to understand how people were advised to seek care for non-COVID-19 health concerns. We found inconsistencies in these communications, ranging from messages to not attend healthcare services because of possible COVID-19 surges, to messages with vague, or lack of, information. Government messages did include advice for seeking general healthcare, but this was largely rendered invisible due to the focus on 'staying home, saving lives'. Media messaging was similarly influenced by these Government directives. Few GP clinics had websites, and few provided information about accessing general healthcare services. Clinics also lacked up-to-date telephone messages about seeking healthcare for non-COVID-19 symptoms and illnesses. All three sources neglected the cultural, social and contextual diversity of the local audience. We recommend that communication during disasters should be clear, concise and consistent. Further, GPs should be supported to have websites and telecommunication platforms. All communications should be inclusive and aim to reach diverse audiences. [ABSTRACT FROM AUTHOR]

Abstract Background Bihar state in India has one of the highest rates of maternal and infant mortality in South Asia. Microfinance-based self-help groups (SHGs), involving rural women, are being utilized to improve maternal and child health practice and reduce mortality. SHG members receive information on key maternal and child health practices as well as encouragement for their practice. This study measures the association of health messaging to SHG members with their antenatal care (ANC) behaviors. Methods The study was conducted in eight districts of Bihar in 2016. A three-stage cluster sampling design (with a random selection of blocks, villages, and SHGs) selected the sample of 1204 SHG members who had an infant child; of these, 597 women were members of SHGs that received dedicated sessions on health messages, while 607 women belonged to SHGs that did not. To examine the impact of the health intervention on ANC practice, radius caliper method of propensity score matching controlled for various socio-demographic characteristics between the two groups. Results Most of the interviewed women (91.5%) belonged to a scheduled caste or tribe. Nearly 44% of SHG members exposed to the health intervention were engaged in some occupation, compared to 35% of those not exposed to the intervention. After matching unexposed SHG women with exposed SHG women, no significant differences were found in their socio-demographic characteristics. Findings suggest that exposure to a health intervention is associated with increased likelihood of at least four ANC visits by SHG women (ATE = 7.2, 95% CI: 0.76–13.7, p

Public efforts to limit the spread of the coronavirus rely on motivating people to cooperate with the government. We test the effectiveness of different governmental messengers to encourage preventive health actions. We administered a survey experiment among a sample (n = 1,545) of respondents across the United States, presenting them with the same social media message, but experimentally varying the government sender (i.e., Federal, State, County, a combination of Federal + County, and a control condition) to test whether local relevance influences messaging efficacy. We find that in an information saturated environment the messenger does not matter. There is, however, variation in treatment response by partisanship, education, income, and the degree to which respondents are affected by the pandemic. While the main effect of the level of government on intended behavior is null, public health organizations are universally perceived as more trustworthy, relevant, and competent than anonymous messengers.

ABSTRACT: Background: People who use drugs have been particularly vulnerable during the COVID-19 pandemic because of their unique social, harm reduction, and treatment needs. These unique needs and challenges have significant influence on the severity of their substance use, mental health symptomatology, willingness to engage in treatment, and adherence to treatment options. This has included immense challenges related to the dissemination of COVID-19 messaging and the need for harm reduction and treatment service entities to adopt new formats to continue operation. Methods: In-depth interview data were collected people who use drugs (N=24) residing in Oklahoma from November 2020 through February 2021 to assess perspectives on (1) their access to harm reduction, substance use prevention, and treatment programs during the COVID-19 pandemic, (2) the perceived quality of such services and programs during this time, and (3) the perceived availability of tailored COVID-19 information. Results: Several factors emerged related to accessing and quality of substance use services during COVID-19, including poor accessibility (e.g., internet access), diminished quality (i.e., lack of social support), and lack of tailored COVID-19 prevention and treatment messaging. Conclusions: Upticks in COVID-19 cases and deaths are expected to continue as new SARS-CoV-2 variants are introduced. The present findings highlight the need for tailored COVID-19 messaging (e.g., minimizing the sharing of substance use supplies that can spread COVID-19, mask wearing, COVID-19 vaccination), which is responsive to unique needs of substance using populations. Similarly, as prevention and treatment programs are delivered online, efforts are necessary to ensure equitable access and enhanced quality of services.

COVID-19 has impacted the lives of many Canadians physically, emotionally, and financially. This commentary focuses on suggestions on how to use social media platforms to target Canadians to promote public COVID-19 related health messaging. Policy strategies that limit the use of algorithms for social media in an effort to eliminate opinion silos and provide users with a more well-rounded view of current events are explored.

Background: Health campaign interventions, particularly those tailored to the target audience’s needs and preferences, can cost-effectively change people’s attitudes and behaviors towards better health decision-making. However, there is limited research on how to best tailor seasonal influenza vaccination campaigns for young adults. Vaccination is vital in protecting young adults and their social circles (vulnerable populations like older adults) from the influenza virus and critical in shaping these emerging adults’ vaccination habits in the long run. However, amid the prevalence of easily-accessible, attention-grabbing, and often malicious false and misinformation (e.g., COVID-19 vaccine conspiracy theories), it may be more challenging to develop vaccination messages that resonate with young adults well enough to attract their attention. Therefore, to bridge the research gap, this study examines young adults’ preferences for seasonal influenza vaccination campaigns to inform effective intervention design and development. Methods: Qualitative survey questions were developed to gauge young adults’ preferences for seasonal influenza vaccination campaigns. A total of 545 young adults (73.9% female, Mage ​= ​19.89, SD ​= ​1.44) from a large University offered complete answers to a cross-sectional online survey. Braun and Clarke’s thematic analysis procedures were adopted to guide the data analysis process. Results: Thematic analysis revealed that young adults prefer seasonal influenza vaccination campaigns that rely on (1) quality and balanced information from (2) credible information sources, positioned in the (3) relevant health contexts, (4) emphasize actionable messages, and incorporate (5) persuasive campaign design. Interestingly, while many participants underscored the importance of fear-appeal messages in persuading them to take health actions, some young adults also suggested avoiding fear campaigns due to discomfort. Conclusions: Insights of the study can inform seasonal influenza vaccination design and development, and have the potential to shed light on vaccination messaging in other vaccine contexts, such as COVID-19 vaccines. Results also underscore the need for health experts and government officials to adopt a more nuanced approach when selecting persuasive campaign appeals. While some young adults may resonate well with fear appeals, others may not. Future research could examine the underlying mechanisms that drive young adults’ preference for vaccination campaign intervention to enrich the literature further.

The purpose of this study was to characterize COVID-19 content posted by users and disseminated via TikTok, a social media platform that has become known largely as an entertainment platform for viral video-sharing. We sought to capture how TikTok videos posted during the initial months of the COVID pandemic changed over time as cases accelerated. This study is an observational analysis of sequential TikTok videos with #coronavirus from January to March 2020. Videos were independently coded to assess content (e.g., health relatedness, humor, fear, empathy), misinformation, and public sentiment. To assess engagement, we also codified how often videos were shared relative to their content. We coded 750 videos and approximately one in four videos tagged with #coronavirus featured health-related content such as featuring objects such as face masks, hand sanitizer, and other cleaning products. Most videos evoked "humor/parody," whereas 15% and 6% evoked "fear" and "empathy", respectively. TikTok videos posted in March 2020 had the largest number of shares and comments compared with January and February 2020. The proportion of shares and comments for "misleading and incorrect information" featured in videos was lower in March than in January and February 2020. There was no statistical difference between the share and comment counts of videos coded as "incorrect/incomplete" and "correct" over the entire time period. Analyzing readily available social media platforms, such as TikTok provides real-time insights into public views, frequency and types of misinformation, and norms toward COVID-19. Analyzing TikTok videos has the potential to be used to inform public health messaging and public health mitigation strategies. [ABSTRACT FROM AUTHOR]

Background: Health care professionals are continually challenged by the need to provide health information in a way that successfully changes health practices. Research has documented this as a concern in relation to safe infant sleep health campaigns. Often, caregivers' knowledge of recommended practices is not associated with a change in infant sleep choices. Purpose: Health campaigns, including most safe infant sleep efforts, often share specific risk factors and steps for avoiding risk, that is, in a verbatim format. Research has shown that caregivers' behavior may be more likely to change when presented with messages based on their general understanding of risk, that is, gist-based format. This research examines caregivers' responses as related to verbatim- and gist-based safe sleep information. Methods: Five hundred forty-one caregivers of infants were shown 12 images depicting infants in safe or unsafe sleep spaces. Images varied across three commercially available spaces, infant race, and presence/absence of one policybased risk factor. Results: Differences in caregivers' discernment of safe and unsafe sleep images paralleled reported differences in knowledge of safe sleep recommendations. Discernment of safe/unsafe images was greater for White than Black caregivers, as well as for females in comparison with male caregivers. Gist-based considerations, such as familiarity with the sleeper depicted or infant race, were also associated with caregivers' discernment of safe/unsafe images. Implications for practice: Attending to both gist- and verbatim-based knowledge regarding safe infant sleep campaign information may help to effectively facilitate caregivers' ability to always create safe sleep spaces for their infants. [ABSTRACT FROM AUTHOR]

Socioeconomic status (SES)-related health disparities persist for numerous chronic diseases, with lower-SES individuals exhibiting greater risk of morbidity and mortality compared to their higher-SES counterparts. One likely contributor is disparities in health messaging efforts, which are currently less effective for motivating health behavior change among those lower in SES. Drawing on communication neuroscience and social neuroscience research, we describe a conceptual framework to improve health messaging effectiveness in lower SES communities. The framework is based on evidence that health-message-induced activity in the ventral striatum (VS) and subdivisions of the medial pre-frontal cortex (MPFC) predicts behavior change. Additionally, we draw from social neuroscience work showing that activity in these regions during valuation and the processing of self-related vs. social information, differs as a function of SES. Bringing together these previously disparate lines of work, we argue that health messages emphasizing the benefits to close others (vs. the self) of engaging in behavior change will be more effective among lower SES individuals. We also outline a research agenda based on our framework. Ultimately, we hope that this framework utilizing a “brain-as-predictor” approach generates novel insights about the neural underpinnings of message-induced behavior change among lower SES individuals, and helps to close the gap in SES-based health disparities by harnessing the power of neuroimaging.

Socioeconomic status (SES)-related health disparities persist for numerous chronic diseases, with lower-SES individuals exhibiting greater risk of morbidity and mortality compared to their higher-SES counterparts. One likely contributor is disparities in health messaging efforts, which are currently less effective for motivating health behavior change among those lower in SES. Drawing on communication neuroscience and social neuroscience research, we describe a conceptual framework to improve health messaging effectiveness in lower SES communities. The framework is based on evidence that health-message-induced activity in the ventral striatum (VS) and subdivisions of the medial pre-frontal cortex (MPFC) predicts behavior change. Additionally, we draw from social neuroscience work showing that activity in these regions during valuation and the processing of self-related vs. social information, differs as a function of SES. Bringing together these previously disparate lines of work, we argue that health messages emphasizing the benefits to close others (vs. the self) of engaging in behavior change will be more effective among lower SES individuals. We also outline a research agenda based on our framework. Ultimately, we hope that this framework utilizing a "brain-as-predictor" approach generates novel insights about the neural underpinnings of message-induced behavior change among lower SES individuals, and helps to close the gap in SES-based health disparities by harnessing the power of neuroimaging. [ABSTRACT FROM AUTHOR]

Young adults consume most of their alcohol by binge drinking, and more than one-third report binge drinking in the past month. Some will transition out of excessive drinking, while others will maintain or increase alcohol use into adulthood. Public health campaigns depicting negative consequences of drinking have shown some efficacy at reducing this behavior. However, substance use in dependent individuals is governed in part by automatic or habitual responses to drug cues rather than the consequences. This study used functional magnetic resonance imaging to measure neural responses to drinking cues and drinking cues paired with antidrinking messages among young adults who binge drink (N = 30). This study also explored responses to smoking cues and antismoking messages. Neural responses were also compared between drinking/smoking and neutral cues. Self-reported drinking and smoking were collected at baseline, postscan, and 1 month. Results indicate that activity in the ventral striatum-implicated in reward processing-was lower for drinking cues paired with antidrinking messages than drinking cues. This difference was less pronounced in young adults who reported greater baseline past month drinking quantity. Past month drinking quantity decreased from baseline to 1 month. Further, young adults who showed higher activity during antidrinking messages in the medial prefrontal cortex-implicated in processing message self-relevance- reported a greater decrease in past month drinking frequency from baseline to 1 month. Findings may help to identify young adults who are at risk for continued heavy drinking in adulthood and inform interventions aimed to reduce drinking and reward in young adults. [ABSTRACT FROM AUTHOR]

Global efforts are focusing on improving survival and well-being of women and children; yet an alarming lack of basic health knowledge exists within communities. The Healthy Happy Families programme was delivered to a variety of groups in a rural and an urban setting in Kwazulu Natal in South Africa with the aim of disseminating key messages about healthy pregnancy, breastfeeding and interacting with the baby through members of the communities themselves. The training was supported by a specially designed, low literacy booklet. Much of the information in the programme was 'heard' by participants for the first time, despite being available in clinics and through the media. The article is illustrated with pages from the programme booklet. [ABSTRACT FROM AUTHOR]

Smoking continues to be a major public health problem, despite a substantial decline in prevalence rates over the last decades. Quit smoking interventions typically target smokers, whether through individual or group treatment or through broader public health campaigns. Yet, nonsmokers represent a vast and largely untapped resource to help smokers quit. This article describes an innovative approach that targeted nonsmokers through a media-style campaign with repeated reminders about smoking cessation. We tested the nonsmoker intervention in a large randomized trial and showed it to be effective in helping smokers quit. Components of the intervention included repeated mailings with relevant cessation messages over a 10-week period, 2 brief check-in telephone calls, and access to a study Web site. In this article, we discuss details of the intervention development, content, and implementation. [ABSTRACT FROM AUTHOR]

An analysis of three Doctor Who Covid-19 videos featuring Jodie Whittaker and a discussion of how fans may have used these videos as optimistic keystones for pandemic engagement. [ABSTRACT FROM AUTHOR]

Introduction: For African American women in Houston, cervical cancer mortality is disproportionate to their racial and ethnic counterparts. Most notably, lack of human papillomavirus (HPV) screening and vaccination as well as late diagnosis increase cervical cancer mortality. However, cervical cancer is largely preventable. While previous research has identified a few social determinants that are specifically related to cervical cancer (e.g., education, income, neighborhood), there may be a host of additional social and cultural factors that contribute to a lack of preventative behavior., Methods: The present study used concept mapping to explore sociocultural determinants of cervical cancer prevention beliefs among young African American women. N  = 15 African American women, ages 18-25, participated in a group concept mapping session focused on cervical cancer knowledge, beliefs about women's health, and how their social environment and culture play a role in their conceptualization of cervical cancer prevention., Discussion: Five overarching concepts emerged: (1) Screening, (2) Support System, (3) Cervical Cancer 101 (knowledge), (4) Fatalism, and (5) Ease of Prevention., Conclusion: The present study highlights the use of concept mapping for prevention science, particularly in exploratory studies for understanding cervical cancer screening barriers, avenues for intervention, and public health messaging. We discuss the findings and implications for public health research in cervical cancer prevention tailored for African American women., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Carmack, Roncancio, Coleman and McKay.)

Background: Social media platforms are increasingly being used to disseminate messages about prenatal health. However, to date, we lack a systematic assessment of how to evaluate the impact of official prenatal health messaging and campaigns using social media data., Objective: This study aims to review both the published and gray literature on how official prenatal health messaging and campaigns have been evaluated to date in terms of impact, acceptability, effectiveness, and unintended consequences, using social media data., Methods: A total of 6 electronic databases were searched and supplemented with the hand-searching of reference lists. Both published and gray literature were eligible for review. Data were analyzed using content analysis for descriptive data and a thematic synthesis approach to summarize qualitative evidence. A quality appraisal tool, designed especially for use with social media data, was used to assess the quality of the included articles., Results: A total of 11 studies were eligible for the review. The results showed that the most common prenatal health behavior targeted was alcohol consumption, and Facebook was the most commonly used source of social media data. The majority (n=6) of articles used social media data for descriptive purposes only. The results also showed that there was a lack of evaluation of the effectiveness, acceptability, and unintended consequences of the prenatal health message or campaign., Conclusions: Social media is a widely used and potentially valuable resource for communicating and evaluating prenatal health messaging. However, this review suggests that there is a need to develop and adopt sound methodology on how to evaluate prenatal health messaging using social media data, for the benefit of future research and to inform public health practice., (©Nessie Felicia Frennesson, Cheryl McQuire, Saher Aijaz Khan, Julie Barnett, Luisa Zuccolo. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 20.12.2023.)

We examine how shifts in subjective age influence consumer health-related attitudes. In Study 1, participants made to feel subjectively young (vs. old) exhibited more positive attitudes after viewing a health-related marketing message. Underlying this effect, subjectively young (vs. old) participants experienced higher levels of self-esteem. Study 2 tested our process by manipulating subjective physical, as opposed to mental age. Our research is the first to investigate the impact of temporary changes in subjective age on consumer attitudes towards healthy behaviors, and the first to compare the effects of mental (vs. physical) subjective age on these attitudes. [ABSTRACT FROM AUTHOR]

Abstract Objectives The purpose of this research was two-fold: (1) to explore the relationship between descriptive and injunctive norm perceptions on stair-use, and (2) to examine the impact of social and non-social stair prompts on stair use. Design Study 1 employed a cross-sectional design, and Study 2 had a time-series experimental design, with two baseline periods and two intervention periods. Method A total of 226 adults completed the online survey for Study 1, reporting their social norm perceptions and individual stair use. For Study 2, 8007 individuals entered the stairwell or elevator over the four-week observation period, either measured by infrared people-counters installed across the entrance to the stairs or by observed trainers positioned near the elevators. Results Study 1 showed a positive relationship between descriptive and injunctive norm perceptions and individual stair use. Study 2 found social prompts to significantly increase the proportion of individuals taking the stairs compared to baseline. The non-social prompts did not increase stair use beyond the effects of the social prompts. Conclusions Individuals perceptions of what is typical and/or desirable behaviour relates to individuals self-reported stair use. Further, findings support the use of social messages as an alternate message for prompting stair use in a university setting. Health practitioners may wish to harness the power of social influence and emphasise that stair use is typical and desirable. Highlights • Social norms positively related to behaviour beyond an individual's reasons for taking the stairs. • Both descriptive and injunctive norm perceptions related to physical activity. • Stair prompts targeting individuals' social motivations led to increased stair use. [ABSTRACT FROM AUTHOR]

Background: Despite the high prevalence of tobacco use during pregnancy among Alaska Native and American Indian (AI/AN) women, few efforts have focused on developing tobacco cessation interventions for this group. This paper describes development of messaging for a social media campaign targeting the entire community to reduce tobacco use in pregnancy (cigarette smoking and smokeless tobacco use including a homemade product known as Iqmik) among AN women, as part of a multi-component intervention. Method: The study (clinical trial registration #NCT02083081) used mixed methods with two rounds of assessments to develop and refine culturally relevant message appeals. Round 1 used qualitative focus groups and individual interviews (n = 60), and Round 2 used quantitative survey interviews (n = 52). Each round purposively sampled adult AN pregnant women, family/friends, and Elders in Western Alaska, and included tobacco users and non-users. Round 1 also assessed reasons for tobacco use in pregnancy. Results: Qualitative findings generally converged with quantitative results to indicate that many participants preferred factual, loss-framed, visual concepts on how maternal tobacco use harms the fetus, newborn, and child in contrast to spiritual or emotional appeals, or gain-framed messaging. Stress was indicated as a major reason for tobacco use in pregnancy and strategies to manage stress along with other health pregnancy targets (e.g. prenatal care) were suggested. Conclusions: This preliminary study suggests campaign messages targeting the entire community to reduce tobacco use in pregnancy among rural AN women should include factual messaging for being tobacco-free as well as focus on reducing stress and other healthy pregnancy targets. [ABSTRACT FROM AUTHOR]

Summary: Hepatitis C virus (HCV) infection is a major public health concern. Globally, 15% of those incarcerated are HCV‐antibody positive (anti‐HCV). Even where HCV treatment is available within prisons, treatment uptake has remained low. This qualitative study was conducted to understand the barriers and facilitators for the delivery of HCV treatment in prisons from the perspectives of prisoners. This is important to inform health messaging for HCV treatment within correctional institutions. Thirty‐two prisoners (including eight women) with a history of injecting drug use participated in this qualitative study. Participants were equally recruited across four correctional centres (n = 8 per site). Overall, 16 participants (50%) had chronic HCV at their most recent test, and two participants were awaiting test results at time of interview. Structural (eg proximity of health clinic) and patient‐level (routine and motivation) factors were viewed as facilitators of HCV treatment within the prison setting. Structural (eg risk of reinfection) and social (eg lack of confidentiality and lack of social support) factors were perceived as barriers to prison‐based HCV care and treatment. In conclusion, to increase HCV treatment uptake, prison‐based programmes should implement (or advocate for) patient‐centred treatment approaches that protect privacy, provide social support, and promote access to clean needles and substitution therapy to protect prisoners from reinfection. [ABSTRACT FROM AUTHOR]

This article aims to determine how Alzheimer's disease (AD) framing impacts on attitudes and self-reported emotions towards the disease. We designed posters with framed messages based on the person with AD: Dualism of body and mind, Unity of body and mind, and control (Study 1, N = 261) and based on the relationship person with AD-family: No reciprocation, Good Mother, and control (Study 2, N = 240). To analyse the effect of the different frames, attitudes towards AD were measured twice (before and after the posters display). Emotions emerging from this exposure were also recorded. Data analysis yielded four significant findings regarding communication on AD: (1) deproblematizing frames (i.e., Unity of body and mind and Good Mother) lead to a positive attitude change; (2) Non reciprocation frame reduces positive attitudes; (3) problematizing frames (i.e., Dualism body and mind and Non reciprocation) trigger negative emotions; (4) deproblematizing frames induce higher positive feelings, which increase positive attitudes. Negative representations about AD reinforce the negative attitudes towards it. Reframing AD is essential to achieve a positive attitudinal change. The use of deproblematizing frames (i.e. , Unity of body and mind or Good Mother) should be considered when developing and implementing policies targeted at communication and awareness of AD to reduce the stigma associated with this disease. • Attitudes towards Alzheimer's disease are influenced by the messages used (frames). • Deproblematizing frames lead to a positives attitude change towards Alzheimer's disease. • Problematizing frames trigger negative emotions. • Reframing Alzheimer's disease is essential to overcome stigma. [ABSTRACT FROM AUTHOR]

Many patients prefer lean physicians to physicians with obesity and place higher credence in their weight management advice. Because genetic information about weight can be viewed as self-serving for individuals with overweight or obesity, physicians with obesity may be discounted when sharing such information. As provision of genetic information regarding weight becomes increasingly common in public health messaging, could a physician's own weight influence how these messages are received by the public? In an online survey, 967 participants were randomly assigned a physician profile (lean v. has obesity) with a media interview transcript discussing genetic factors of a common health condition (obesity v. osteoporosis). Participants perceived the physician with obesity who discussed genetic factors in obesity as less trustworthy and less credible. Participants were also less likely to anticipate following her advice on weight-related issues. Participants with higher BMI had less negative perceptions of this physician. Physicians with obesity, when providing public health messaging regarding genetic information about obesity, may be met with distrust and negative attitudes toward the physician. Future research should investigate health communication strategies that address this form of weight stigma while accurately conveying genetic factors that contribute to weight. • Physician weight influences how messages about weight are perceived by the public. • Discussing genetics of obesity amplifies bias against physicians with overweight. • High participant BMI is associated with less bias against physicians with overweight. • Future work is needed on strategies to reduce weight bias in public health settings. [ABSTRACT FROM AUTHOR]