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This paper explores the Vietnamese government's approach toward public health risk communication in the context of citizen mobilization during the Covid-19 pandemic. We analyze the government's communication strategy using images and videos published during the pandemic, such as artwork, leaflets, campaigns, music videos, and public announcements in public spaces. The government's visual risk communication strategy is embedded in an idealized vision of cooperative citizenship. The focus is on the moral obligation of citizens toward the Vietnamese nation and the morality of caring, in which the state communicates behavior it deems morally correct. [ABSTRACT FROM AUTHOR]

Public health communication campaign planners must carefully consider whether misinformation beliefs are important to target and, ideally, correct. Guided by the reasoned action approach, we hypothesized that behavior-specific beliefs regarding COVID-19 vaccination would account for any observed relationship between general coronavirus misinformation beliefs (misinformation beliefs that are not specific to the anticipated consequences of COVID-19 vaccination) and subsequent vaccine uptake. To test our hypothesis, we used panel data from a two-wave nationally representative sample of U.S. adults pre- and post-vaccine availability (T1: July 2020, T2: April/June 2021, analytic sample: n = 665). Contrary to our hypothesis, we find a residual observed relationship between general coronavirus misinformation beliefs and subsequent vaccine uptake (AOR = 0.40, SE = 0.10). Intriguingly, our post-hoc analyses do show that after also adjusting for T2 behavioral beliefs, this association was no longer significant. With this and other justifications, we recommend that messages promoting vaccination prioritize targeting relevant behavioral beliefs. [ABSTRACT FROM AUTHOR]

To design effective health messages, this study investigates the effects of gain-loss framing and relevant moderating effects in the context of college students' alcohol use. Specifically, based on an online experiment, we tested the moderation effects of message-sidedness and binge-drinking behaviors using a mediation model in which the association between gain-loss framing and behavioral intentions is mediated by attitudes toward binge-drinking. Four hundred thirty-four Korean college students participated in this study. Hayes' PROCESS Macro for SPSS was employed for the analysis. The results show that loss-framing significantly increased participants' unfavorable attitudes toward binge-drinking in the one-sided message condition. Moreover, attitudes toward binge-drinking were more significantly associated with behavioral intentions to binge-drink among heavy drinkers than among non-heavy drinkers. Our findings suggest important theoretical and practical implications for the development of message-framing strategies in health campaigns designed to prevent college students' binge-drinking in collectivistic societies where the cultural meaning of drinking extends beyond the individual realm to the larger social context. [ABSTRACT FROM AUTHOR]

This study aimed to investigate vaccine promotion messages, examine the heterogeneous effects of these messages and provide experimental evidence to help evaluate the efficiency of COVID-19 vaccine promotion campaigns in Hungary. This study presents the results of three randomised survey experiments that were embedded in cross-sectional, representative, public opinion studies of Hungarian adults based on in-person interviews. Simple randomisation and blinding were applied to assign participants into the control group (no message) or treatment groups (vaccine promotion messages). The first experiment (March 2021) aimed to test vaccination promotion messages from politicians (N = 331) and medical experts (N = 342) by comparing experimental groups' trust in vaccines and conspiratorial beliefs with the control group (N = 327). The second experiment (September 2022) tested the impact of two communication strategies ([1] highlighting the safety and effectiveness of vaccines, N = 104; and [2] highlighting the wide variety of vaccines available, N = 110) on increasing vaccine uptake among those who were still unvaccinated (control group, N = 89). The third experiment (September 2022) tested one message aiming to increase COVID-19 booster uptake among those who received only the first round of vaccination (N = 172; control group, N = 169). The outcome variable in the second and third experiments was intent to get vaccinated. Robust regressions, logit models, Mann–Whitney U-tests and model-based recursive partitioning were run. The inference criteria (p < 0.05) was set in pre-registration of the experiments. All treatment effects were insignificant, but exploratory research found significant conditional treatment effects. Exposure to vaccine promotion by medical professionals was associated with a higher level of trust in Russian and Chinese COVID-19 vaccines in older age cohorts (weighted robust regressions, 50–59 years old, Russian vaccine: +0.769, interaction term [i.t.] p = 0.010; Chinese vaccine: +0.326, i.t. p = 0.044; and ≥60 years old, Russian vaccine +0.183, i.t. p = 0.040; Chinese vaccine +0.559, i.t. p = 0.010) and with a lower level of trust in these vaccines among younger adults (<30 years old, Russian vaccine: −1.236, i.t. p = 0.023; Chinese vaccine: −1.281, i.t. p = 0.022). Receiving a vaccine promotion message from politicians led to a higher level of trust in Chinese vaccines among the oldest respondents (≥60 years: +0.634, i.t. p = 0.035). Short-term persuasion attempts that aimed to convince respondents about COVID-19 vaccination were ineffective. Booster hesitancy, similar to primary vaccine hesitancy, was resistant to vaccine promotion messages. Significant conditional effects suggest that COVID-19 vaccine promotion by medical experts and politicians may have had adverse effects for some demographic groups in Hungary. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Utilizing a constructionist frame analysis to identify key messages, this study investigates the impact of Health Canada news releases on print media coverage during the rollout of the COVID-19 vaccine. Analysis: The analysis focuses on seven frames related to the vaccination rollout: safety and efficacy, global accessibility, domestic accessibility, distribution logistics, distribution timeline, continued preventative measures, and vaccine mistrust. Conclusions and implications: The authors found missed opportunities for public health behaviour frames in Health Canada press releases, significant differences in the framing of the vaccine in press releases versus news reports, and the lack of an agenda-setting effect based on the proportion of frames carried over. [ABSTRACT FROM AUTHOR]

Trust is important in public health communication to culturally and linguistically diverse (CALD) communities during pandemics. This empirical research, using quantitative data from 107 foreign nationals at a university in Shanghai, probes into how trust varied in official translation services (OTS) and non-official translation services (NOTS) during COVID-19. Statistical analysis was carried out by IBM SPSS Statistics 26 and it was found that (1) NOTS which are more frequently used are more trusted compared with OTS; (2) NOTS are uncorrelated with demographics while OTS are correlated with demographics, among which education and trust in OTS suggest a linear positive relationship (Sig. = 0.003, β = 0.467), whereas age and trust in OTS suggest a linear negative relationship (Sig. = 0.027, β = −0.348); (3) there is a positive relationship between the frequency of using services and trust, i.e., higher frequency implies higher trust. The findings of this case study can have implications for policy makers and the representatives of CALD communities. [ABSTRACT FROM AUTHOR]

This experiment examined the feasibility of 360° video as a tool for public health messaging by investigating the effect that viewing the 360° documentary The Waiting Room VR had on female viewers’ sense of identification, attitudes to breast cancer screening and mortality salience. A key part of the documentary places participants in a viewpoint ambiguously aligned to that of the film’s director and subject, Victoria Mapplebeck (VM), in a scene that recreates her radiotherapy treatment for breast cancer. Eighty female participants watched the documentary either sitting upright with the chair back set at a 90° angle or reclining with the chair back set at a 140° angle (consistent with VMs posture) under conditions of either high or low cognitive load. The effect of posture type was measured explicitly using questionnaires on presence, identification and breast self-examination (BSE) intention as well as implicitly using a lexical decision task to measure death-thought awareness (DTA). Reclined posture led to a higher sense of spatial presence but no increase in identification with VM. Significantly increased identification with VM led to greater intention to conduct BSE. There were no effects of posture, cognitive load or identification on DTA. The implications of these results for using 360° video as a behaviour change tool, the effects of the COVID-19 pandemic on the terror management manipulation and the relevance of spatial viewpoint in 360° video are discussed. [ABSTRACT FROM AUTHOR]

Abstract Background Public health professionals have prepared and distributed many messages and materials to convince the public to adopt healthy behaviors or reduce risky behaviors. However, health promotion materials do not always have the desired effect due to a lack of ability to engage target audience. This study examined the effectiveness of humor appeal (i.e. using humor as an advertising technique to attract attention and increase acceptance of the message) in health promotion materials and how to use it effectively. Methods Total 17 printable posters with different frames (loss- vs. gain-framed) × tones (humorous vs. non-humorous) × topics (advance care planning, cancer screening, donor registry, smoking cessation, and physical activity) were created and evaluated for comprehensibility, persuasiveness, and resistance through two web-based surveys. Participants who were Japanese adults aged 25–64 years were randomly assigned one of the posters (200 people each) and asked to rate it. The overall score was calculated as the persuasiveness score (EHPM 2017;22:69) minus the resistance score (EHPM 2022;27:20). Results In the advance care planning case, the highest overall score was found in the gain-framed humorous poster, followed by the loss-framed humorous poster, and the non-humorous poster (p = 0.007). In the other 4 cases, the posters using humorous illustrations received a significantly lower scores than the non-humorous poster(s). Conclusion The use of humor appeal can help improve the acceptability and persuasiveness of the message when dealing with a little-known resistance-prone health topic. Humor appeal will provide an effective hook to direct public attention to what they do not know or care about in public health communication.

Public health is a multidisciplinary field that encompasses a wide range of activities and initiatives aimed at preventing diseases, addressing health disparities, promoting healthy behaviours, studying patterns, and improving the overall health of communities. Within this landscape, comics emerge as a dynamic tool for raising awareness, promoting healthy behaviour, enhancing understanding of public health messages, and effectively reaching diverse audiences, including those with low health literacy and language barriers. Notably, Meredith Li-Vollmer's Graphic Public Health: A Comics Anthology and Roadmap assumes a prominent role in this framework. Published by Graphic Mundi (an imprint of the Penn State University Press) in 2022, this anthology attests to the power of the comic medium to facilitate health communication while delving into a wide-ranging public health-related theme. This email interview with Li-Vollmer follows a tripartite structure. In the inaugural segment, titled 'The Artist,' Li-Vollmer offers a comprehensive exposition of her artistic processes. In the subsequent segment titled 'Comics and Public Health,' Li-Vollmer articulates the capacity of the comic medium to serve as a transformative agent in public health. Finally, in the concluding part, 'Graphic Public Health,' she deliberates on the core principles that shape her 2022 work on graphic public health. [ABSTRACT FROM AUTHOR]

Public health communication acts as a social vaccine in case of pandemics. Prior research has identified that such initiatives often fail to reach vulnerable sections of society. In India, while the first wave of infections mainly hit the urban areas, rural areas witnessed a surge in the second wave. Using the World Bank data, we attempt to understand the effectiveness of public awareness campaigns in rural areas. We use the Ecological Model for public health and find how the various factors relate to public health outcomes. The ecological factors are found to be related to awareness of Covid‐19. We find inadequate awareness about the symptoms and preventive measures associated with Covid‐19 among the rural population. We also find significant differences in communication and awareness along dimensions such as education and access to media. The role played by SHGs and hospitals in dealing with pandemics is also evident in this study. We conclude that the disparity in public health communication needs to be bridged to ensure equitable access to health information in society during public health crises. [ABSTRACT FROM AUTHOR]

Dissemination of public health information plays an essential role in communicable disease control and prevention. However, widespread and repeated messaging could become counterproductive if it leads to avoidance and disengagement due to message fatigue. Americans have been inundated with accurate and inaccurate COVID-19 information from myriad sources since the start of the pandemic. Using the health belief model (HBM) as a guiding framework, this study examines COVID-19-related message fatigue among adults in the United States who have gotten at least one dose of a COVID-19 vaccine and the association between message fatigue and COVID-19 booster uptake and intentions. A special survey module of The COVID States Project was fielded between August and September 2022 (n = 16,546). Results showed moderately high levels of message fatigue among vaccinated individuals. Message fatigue was negatively associated with the likelihood of having gotten a COVID-19 booster and intentions to do so among those who had not yet received a booster, above and beyond variance explained by the HBM constructs. These findings underscore the importance of monitoring and mitigating COVID-19-related message fatigue in encouraging the public to stay up to date with COVID-19 vaccination. [ABSTRACT FROM AUTHOR]

Linguistically diverse communities face barriers to receiving appropriate health information. COVID-19 exacerbated these health-communication inequities. University of Washington researchers surveyed bilingual staff, students, and medical interpreters – desiring training to become effective communicators of COVID-19 information to their social networks and language communities. In response, the COVID-19 Information Navigator Training was developed and pre-tested with professional networks and members of the target audience. The final training comprised three interactive modules and short quizzes. Evaluation surveys measured Information Navigators' confidence in providing COVID-19 information to their social networks. Surveys included questions on the participants' language or cultural community, the perceived value of the training, and their ability to communicate COVID-19 information. Among 393 participants who enrolled in the training, 284 completed the survey. Significant differences in confidence before and after the course were found in detecting COVID misinformation in the news and social media (pre-course mean: 3.83, post-course mean: 4.63; absolute mean difference was 0.82 points higher in the post-evaluation on the 5-point likert scale, 95% CI: 0.70–0.93, p <.01). Training multicultural volunteers to disseminate information to their social networks is a promising strategy for reaching linguistically diverse communities with up-to-date information during health emergencies. [ABSTRACT FROM AUTHOR]

This study aims to generate evidence-based guidelines for researchers regarding how to effectively disseminate mental health research via Twitter. Three hundred mental health research Tweets posted from September 2018 to September 2019 were sampled from two large Australian organizations. Twenty-seven predictor variables were coded for each Tweet across five thematic categories: messaging; research area; mental health area; external networks; and media features. Regression analyses were conducted to determine associations with engagement outcomes of Favourites, Retweets, and Comments. Less than half (n = 10) of predictor variables passed validity tests. Notably, conclusions could not reliably be drawn on whether a Tweet featured evidence-based information. Tweets were significantly more likely to be Retweeted if they contained a hyperlink or multimedia. Tweets were significantly more likely to receive comments if they focused on a specific population group. These associations remain significant when controlling for organization. These findings indicate that researchers may be able to maximize engagement on Twitter by highlighting the population groups that the research applies to and enriching Tweets with multimedia content. In addition, care should be taken to ensure users can infer which messages are evidence-based. Guidelines and an accompanying resource are proposed. [ABSTRACT FROM AUTHOR]

The present study investigated the latent topics and language styles present in mental health organizational discourse on Twitter. The researchers sought to analyze identifying the prevalence of and language used in social support messaging in tweets about mental health care, the overarching topics regarding mental health care, and predicted that tweets with higher engagement will have increased frequency of words with positively valenced emotion and cognitive processing. A GSDMM was run to uncover latent themes that emerged in a data set of 326.9k tweets and 7.2 m words about organizational discussions of mental health. A generalized linear model using the Poisson distribution was used to assess the role of engagement, positive emotion, and cognitive processing. The study found support for both positive emotion and cognitive processing as statistically significant predictors of engagement. Directions for research include the development of health message strategies, policy needs, and online interventions. [ABSTRACT FROM AUTHOR]

Risk communication during a public health crisis necessitates the provision of accessible, timely and accurate health information to the public. The aim of this research project was to explore the availability and characteristics of COVID-19 and vaccine health promotional materials published in Aboriginal and Torres Strait Islander languages. We aimed to identify the strategies used by Aboriginal-led organizations and Departments of Health to improve communication about COVID-19 and vaccination. Health promotion resources published online between January 2020 and December 2021 were identified by means of a desktop scan and a content analysis was subsequently conducted. We also interviewed five Aboriginal-led organizations and interview data were analyzed thematically. Findings illustrate the vital role of Aboriginal and Torres Strait Islander languages in high stakes information transfer and, in particular, the push by Departments of Health and language groups to create and disseminate important messaging in Aboriginal and Torres Strait Islander languages. This is best achieved by utilizing local knowledge, existing relationships and local connections. Finally, a multimodal approach to the production and dissemination of pandemic health information better caters for the diverse specific needs of these communities. [ABSTRACT FROM AUTHOR]

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Background: Public health professionals have prepared and distributed many messages and materials to convince the public to adopt healthy behaviors or reduce risky behaviors. However, health promotion materials do not always have the desired effect due to a lack of ability to engage target audience. This study examined the effectiveness of humor appeal (i.e. using humor as an advertising technique to attract attention and increase acceptance of the message) in health promotion materials and how to use it effectively. Methods: Total 17 printable posters with different frames (loss- vs. gain-framed) × tones (humorous vs. non-humorous) × topics (advance care planning, cancer screening, donor registry, smoking cessation, and physical activity) were created and evaluated for comprehensibility, persuasiveness, and resistance through two web-based surveys. Participants who were Japanese adults aged 25–64 years were randomly assigned one of the posters (200 people each) and asked to rate it. The overall score was calculated as the persuasiveness score (EHPM 2017;22:69) minus the resistance score (EHPM 2022;27:20). Results: In the advance care planning case, the highest overall score was found in the gain-framed humorous poster, followed by the loss-framed humorous poster, and the non-humorous poster (p = 0.007). In the other 4 cases, the posters using humorous illustrations received a significantly lower scores than the non-humorous poster(s). Conclusion: The use of humor appeal can help improve the acceptability and persuasiveness of the message when dealing with a little-known resistance-prone health topic. Humor appeal will provide an effective hook to direct public attention to what they do not know or care about in public health communication. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic sparked worldwide efforts to combat the health crisis, including vaccine development and distribution. However, varying political responses to vaccination policies complicated public discourse and influenced vaccine acceptance. This research paper employs critical discourse analysis (CDA) to compare (de)legitimation strategies used in Tanzanian political speeches by two presidents: late President Magufuli and current President Samia Suluhu Hassan. The study focuses on their approaches to legitimizing or delegitimizing COVID-19 vaccines in 2021. Two speeches were purposefully selected based on their relevance to vaccination decisions. President Magufuli employed strategies such as discrediting experts, discrediting others, denial, conspiracy theories, and making accusations to delegitimize vaccines. In contrast, President Samia justified vaccine acceptance using strategies such as authorization, moral evaluation, emotional appeals, and rationalization. These differences in approach can be attributed to their respective ideologies. President Magufuli, a populist leader, displayed scepticism towards Western medicine and promoted local solutions, while President Samia presented herself as a pragmatic leader who prioritizes scientific solutions and international cooperation in addressing health crises. The findings shed light on the complexities of public health communication and vaccine acceptance in Tanzania.

Public health is a multidisciplinary field that encompasses a wide range of activities and initiatives aimed at preventing diseases, addressing health disparities, promoting healthy behaviours, studying patterns, and improving the overall health of communities. Within this landscape, comics emerge as a dynamic tool for raising awareness, promoting healthy behaviour, enhancing understanding of public health messages, and effectively reaching diverse audiences, including those with low health literacy and language barriers. Notably, Meredith Li-Vollmer’s Graphic Public Health: A Comics Anthology and Roadmap assumes a prominent role in this framework. Published by Graphic Mundi (an imprint of the Penn State University Press) in 2022, this anthology attests to the power of the comic medium to facilitate health communication while delving into a wide-ranging public health-related theme. This email interview with Li-Vollmer follows a tripartite structure. In the inaugural segment, titled ‘The Artist,’ Li-Vollmer offers a comprehensive exposition of her artistic processes. In the subsequent segment titled ‘Comics and Public Health,’ Li-Vollmer articulates the capacity of the comic medium to serve as a transformative agent in public health. Finally, in the concluding part, ‘Graphic Public Health,’ she deliberates on the core principles that shape her 2022 work on graphic public health. [ABSTRACT FROM AUTHOR]

In Togo, family planning (FP) use remains low; only 24.1% of married woman ages 15 to 49 use modern FP. The West Africa Breakthrough ACTION (WABA) project developed the Confiance Totale radio campaign, which used a Saturation+ approach to encourage FP use. This study presents the results of an evaluation of Confiance Totale which investigates associations between campaign exposure and outcomes of interest. Following the broadcasts, the team conducted a cross-sectional household survey among 2,200 respondents ages 18 to 49. Combined and sex-stratified multivariable models predicting outcomes of interest controlled for sex, age, site, marital status, educational attainment, religion, and economic status. Upon hearing a campaign jingle, approximately 45% of participants had heard the campaign. Exposure to the campaign was associated with many ideational and behavioral outcomes including current use of a facility-dependent FP method (OR = 1.77, p <.001). In stratified models, several outcomes were significantly associated with exposure in the women-only models but not in the men-only models. Exposure to Confiance Totale was associated with nearly all ideational and behavioral outcomes of interest, particularly among women. This demonstrates that high dosage broadcasting may be effective in promoting confidence in the health system and improving perceptions of FP. [ABSTRACT FROM AUTHOR]

Marketers often advertise products high in sugar, fat or calories as healthy products. With this potentially misleading information, they can influence eating decisions with negative consequences for human health. Consumers need the ability to uncover misleading food advertising. However, individuals' perceived knowledge and their actual objective abilities often drift apart – a phenomenon which has come to be known as the Dunning-Kruger Effect. Thus, this study set out to uncover the phenomenon's potential existence in health communication, more precisely in the area of food and media literacy. In a quantitative survey representative of the Austrian population (n = 1000) the Dunning-Kruger Effect (DKE) could be detected: Individuals who were most knowledgeable underestimated their food and media literacy, but – on the positive side – they acted as opinion leaders. Individuals who were least knowledgeable about advertising strategies used to market an unhealthy product as healthy and about the actual nutrition score of the advertised product were most likely to overestimate their own food and media literacy. Worryingly, further concerning consequences emerged, especially for least knowledgeable individuals. The study's results provide important implications for public health campaigns. [ABSTRACT FROM AUTHOR]

When advocating for a behavior, persuasive messaging typically focuses on the context that behavior is performed in, such as mask-wearing during the COVID-19 pandemic. However, situating the advocated behavior in a different context, termed an incongruent context appeal, may persuade by increasing attention, novelty, and memorability. The current study tested this supposition in a message experiment. Participants (N = 324) were randomized to view an incongruent context (e.g. skiing) or a congruent context (i.e. COVID-19) appeal advocating for mask wearing. The incongruence appeal had a direct, positive effect on mask wearing intentions and indirect, positive effects via two serial mediation pathways: time spent with the message increased attention through novelty and memorability. Findings suggest that an incongruent context appeal is an effective strategy for persuading audiences in information-saturated environments like the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Public education campaigns are promising methods for promoting vaccine uptake. In April 2021, the U.S. Department of Health and Human Services launched the We Can Do This COVID-19 public education campaign. This study is one of the first evaluations of this COVID-19 public education campaign. We tested associations between channel-specific campaign exposure (i.e. digital, TV, radio, print, and out-of-home advertising) and COVID-19 first-dose vaccinations among a nationally representative online sample of 3,278 adults. The study introduces novel ways to simultaneously evaluate short- and long-term cumulative media dose, filling an important gap in campaign evaluation literature. We observed a positive, statistically significant relationship between the short-term change in digital media dose and the likelihood of first-dose vaccination, and a positive, statistically significant relationship between long-term cumulative TV dose and the likelihood of first-dose vaccination. Results suggest that both digital and TV ads contributed to vaccination, such that digital media was associated with more immediate behavioral changes, whereas TV gradually shifted behaviors over time. As findings varied by media channel, this study suggests that public education campaigns should consider delivering campaign messages across multiple media channels to enhance campaign reach across audiences. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has highlighted the need for research about communicating with populations who have limited English proficiency in the United States during infectious disease outbreaks. These populations have experienced significantly worse health outcomes during emergencies, including the COVID-19 pandemic, and evidence-based risk communications are critical to protecting their health. To support improved development of emergency communications for these communities, we conducted a scoping review that examined the extent of research available, with an intent to identify which communications topics are covered in the literature and where research gaps exist. Following the JBI framework, with reporting guided by the PRISMA extension for scoping reviews, 6 electronic databases were systematically searched in October 2022. The inclusion criteria for articles selected were: data collected between 2009 and 2022, published in English, and focused on communications pertaining to emergency infectious disease outbreaks (eg, H1N1 influenza, Zika virus, COVID-19) for populations with limited English proficiency. Of 2,049 articles identified through the search, 31 met the inclusion criteria and were selected for review. We identified major limitations in the evidence base: a majority of studies were conducted only among Spanish speakers or during the COVID-19 pandemic, and most used qualitative or nonrandom samples. Most studies documented basic language barriers in communications, but there was little exploration of more nuanced barriers, such as cultural relevance or social context. Ahead of future outbreaks, more research is urgently needed to examine the information landscapes of populations with limited English proficiency, to inform the development of more effective communications strategies from public health institutions and others. [ABSTRACT FROM AUTHOR]

IntroductionSchools were uniquely impacted during the COVID-19 (SARS-COV-2) pandemic. We sought to elucidate how parents/guardians of elementary and middle school students in Maryland navigated the return to in-person school following remote instruction. We also sought to understand how they perceived communication about school-based COVID-19 mitigation strategies and their preferences for the content and format of public health communication about COVID-19 mitigation in schools.MethodsWe engaged a community advisory board comprised of key partners and implemented a survey and focus groups.ResultsResults indicated that parents/guardians wanted clearer communication about COVID-19 mitigation policies in schools and were experiencing fatigue and confusion. These insights informed the development of a tailorable communication toolkit. The toolkit was designed to (1) inform parents/guardians about the importance and effectiveness of mitigation strategies for preventing viral spread to keep children in school, (2) promote a sense of community and support, and (3) help school communication teams effectively communicate information about mitigation strategies being implemented.DiscussionWe describe a process for leveraging schools as a trusted messenger, engaging school communities in the development of communication messages, and utilizing a tailorable communication toolkit in the context of shifting public health guidance and local needs. The toolkit development and dissemination process offers a model for targeting public health messaging to parents/guardians in school settings.

Abstract Background The success of the COVID-19 vaccination roll-out depended on clear policy communication and guidance to promote and facilitate vaccine uptake. The rapidly evolving pandemic circumstances led to many vaccine policy amendments. The impact of changing policy on effective vaccine communication and its influence in terms of societal response to vaccine promotion are underexplored; this qualitative research addresses that gap within the extant literature. Methods Policy communicators and community leaders from urban and rural Ontario participated in semi-structured interviews (N = 29) to explore their experiences of COVID-19 vaccine policy communication. Thematic analysis was used to produce representative themes. Results Analysis showed rapidly changing policy was a barrier to smooth communication and COVID-19 vaccine roll-out. Continual amendments had unintended consequences, stimulating confusion, disrupting community outreach efforts and interrupting vaccine implementation. Policy changes were most disruptive to logistical planning and community engagement work, including community outreach, communicating eligibility criteria, and providing translated vaccine information to diverse communities. Conclusions Vaccine policy changes that allow for prioritized access can have the unintended consequence of limiting communities’ access to information that supports decision making. Rapidly evolving circumstances require a balance between adjusting policy and maintaining simple, consistent public health messages that can readily be translated into action. Information access is a factor in health inequality that needs addressing alongside access to vaccines.

Public health interventions targeting coughing and spitting during the Tuberculosis and 1918 flu epidemics were largely successful. Specifically, public health officials' messaging framed the behavior of spitting as repulsive and endangering to others, prompting an elicitation of disgust. Anti-spitting campaigns – messaging that focuses on the threat of spit or sputum – have long been common during pandemics and manifested once again to combat the spread of COVID-19. Yet, few scholars have theorized if and how anti-spitting campaigns function to change behavior. One possibility is parasite stress theory, which posits that human behavior is driven by a desire to avoid pathogenic threats like spit. The application of these types of disgust appeals in public health messaging remains understudied and warrants exploration. To test the applicability of the parasite stress theory, our message experiment with US adults (N = 488) examined reactions to anti-spit messages that varied in visual disgust (low and high). For more highly educated respondents, the high disgust appeal directly decreased spitting intentions, and this relationship was stronger for individuals with higher levels of pathogen and moral disgust. Given the importance of public messaging during pandemics, future research should continue to examine the efficacy and theoretical underpinnings of specific disgust appeals. [ABSTRACT FROM AUTHOR]

The Federally Qualified Health Centers (FQHCs) in Wisconsin serve the most under-resourced communities in the state and are trusted sources in local communities. Although healthcare workers can be leveraged to champion COVID-19 vaccines, existing vaccine hesitancy among the FQHC workforce itself calls for research to identify promising messaging themes that can boost their vaccine confidence. In spring 2021, through a partnership with the Wisconsin Primary Health Association, we took a community-engaged approach to develop and field a survey including 46 beliefs (Ms = 1.36–4.25, SDs = 0.81–1.46, all on 5-point Likert scales) among employees of 10 out of the 17 FQHCs in Wisconsin. In total, 347 clinical team members and 349 non-clinical staff members (a) indicated their levels of (dis)agreement with all 46 belief items and (b) reported vaccine acceptance (dichotomized, acceptance = 77.6%) as well as recommendation intentions (dichotomized, yes = 73.9%). We carried out the Hornik & Woolf analyses in a multilevel logistic regression framework with bootstrapping to rank order all beliefs, segmented by subgroup and behavioral outcome. Our results suggest that communication-based interventions should promote beliefs such as those related to perceived safety and efficacy, rather than normative pressure from peers, while aiming to reduce doubts about information withholding and manipulation, the safety of the mRNA technology, the approval process, and "unnatural" ingredients in the vaccines. Subgroup-specific belief rankings are also provided. This study demonstrates the usefulness of incorporating the H&W approach into community-engaged research with local healthcare systems to improve health messaging for vaccine promotion. [ABSTRACT FROM AUTHOR]

This study explores how people engage with educational and motivational content on TikTok. We conducted a mixed-methods content analysis of N = 400 health videos from the prosocial EduTok campaign. Two theories guided our analysis of content: the motivational theory of role modeling and the health belief model. Our results revealed that audiences most frequently engaged with educational videos related to diet, exercise, and sexual health. Role model appeals were prominently featured and highly engaged with. However, these videos often framed health promotion through an ideal lens, without including information needed for behavior change attainability. The prevalence of constructs from the health belief model in videos varied. Videos emphasizing prevention, cues to action, and behavior antecedents including perceived benefits and severity attracted more views and engagement than videos that did not include these concepts. We further observed a trend in which content creators used severity in a sensational manner to elicit shock and outrage, which in turn boosted content virality. When included, videos featuring efficacy appeals garnered higher engagement. However, these appeals were less common and had limited reach. Overall, our findings provide implications for using role modeling and theory-driven appeals in social media eHealth communication. [ABSTRACT FROM AUTHOR]

In 1774, Dr. Joseph Ignacio Bartolache had an instructional text printed to market a new drug among the Spanish and Indian population of New Spain. Although this document bears witness to the vernacularization of medical knowledge and recognizes the linguistic diversity of New Spain at the end of the 18th century, it also shows a change from previous centuries in the configuration of medical pluralism in the region. It reveals how health communication was already approached from a dominant and homogenizing perspective, not unrelated to cultural distancing, the emergence of the scientistic paradigm as a civilizing imaginary, and the incorporation of indigenous communities into the Euro-Creole pharmaceutical market. However, it experienced very limited success as a strategy due to its translation. [ABSTRACT FROM AUTHOR]

A key goal of health communications designed to prevent smoking initiation during adolescence is for the tobacco-related information to be retained in memory beyond immediate message exposure. Here, we test the role for epistemic emotions, specifically curiosity and surprise, in facilitating memory for tobacco-related health information. Participants (n = 294 never-smoking adolescents, ages 14–16 years) performed a trivia guessing task wherein they guessed the answers to general trivia and smoking-related trivia questions. A subset of participants (n = 154) completed a surprise trivia memory task one week later and answered the previously viewed questions. Results indicate that curiosity about the answers to smoking-related trivia is associated with more accurate recall of smoking-related trivia answers one week later. Surprise also facilitated memory for smoking-related trivia, but the association was limited to cases where confidence in prior knowledge was low. Indeed, when participants had high confidence in their prior knowledge, surprise about the answer to trivia questions was associated with worse recall. Findings suggest that engendering states of curiosity for smoking-related information may facilitate retention of that information in never-smoking adolescents and highlight the need to examine both surprise and confidence in health communications to avoid low message recall. [ABSTRACT FROM AUTHOR]

The coronavirus disease (COVID−19) was the third leading cause of death in 2021 in the United States and has led to historic declines in life expectancy for Americans. While vaccination is an effective mitigation strategy for COVID−19, vaccine hesitancy remains a major barrier to individual and population-level protection. An emerging literature on hesitant adopters of COVID−19 vaccines highlights co-occurrence of hesitancy and vaccine uptake as an understudied phenomenon, with the potential to provide insight into factors that lead hesitant individuals to become vaccinated despite their hesitancy. We use qualitative interviews among hesitant adopters in Arkansas to examine vaccine hesitancy among this understudied group. Drawing on the Increasing Vaccination Model, we find that the most frequently reported motivations of hesitant adopters were within the domain of social processes, pointing to a critical focal point for targeted health communications intervening in this domain (e.g. social norms, social networks, and altruistic behavior). We find that recommendations from health care workers (HCWs) other than physicians/providers may serve as an effective influence to vaccinate. We also demonstrate negative effects of low provider and HCW confidence and weak recommendations on motivations to vaccinate among individuals expressing vaccine hesitancy. Additionally, we find individual information-seeking behaviors among hesitant adopters bolstered confidence in the efficacy of the COVID−19 vaccine. Based on these findings, clear, accessible, and authoritative health communication has a role in combatting the COVID−19 misinformation/disinformation infodemic. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has brought on an unprecedented amount of information about the virus and vaccination, varying significantly across information channels. While extant research shows that excessive information leads to overload and less elaboration, few studies have examined factors associated with information overload and elaboration. Considering the trend that we likely receive information on the same topics from different communication channels daily, this study sought to understand how cross-channel differences in the information were associated with information overload and subsequent elaboration. The survey assessed 471 participants' consumption of COVID-19 information across different channels (interpersonal communication vs. social media), concern about information quality, information overload, information elaboration, health literacy, and demographic characteristics in February 2021. Our findings confirmed that greater information overload was negatively associated with more information elaboration. Using a moderated mediation model, we found that people who received more information from social media, compared to those who received equal amounts of information from both social media and interpersonal communications, reported more information overload and less elaboration. Additionally, we found that people who experienced greater information overload and held greater concern about information quality tended to elaborate more information. All analyses were controlled for health literacy. Theoretical and practical implications were discussed. [ABSTRACT FROM AUTHOR]

In this paper, we integrate the stress process model with symbolic interactionism to frame our analysis of interviews with 35 women who were pregnant and/or gave birth during the first year of the Covid‐19 pandemic. We detail three stressors, highlight their variation, and discuss how they coped with these stressors. Women reported having to navigate contradictory information about the public health crisis, but Black participants simultaneously endured added strain from a heightened awareness of racialized violence. To cope with an overabundance of precarious and contradictory messages, some women sought out information (i.e., information gatherers), others eschewed information (i.e., information avoiders), and most established protective "bubbles." Next, women experienced disruptions in pregnancy rituals but coped by reframing their expectations. This stressor, however, was less acute for women with a prior birth. Third, women shared feelings of social isolation and reduced social support, which were intensified if pregnancy complications occurred. Women coped by relying on telecommunication and at‐home monitoring devices. Our study shows how pregnant women experienced and coped through adversity to mitigate stressors amid pandemonium. [ABSTRACT FROM AUTHOR]

While psychological reactance is often invoked to explain the unintended boomerang effects of persuasive health messages, underlying processes that might explain how reactance affects behavior are rarely studied. We investigated whether messages that elicit reactance can bias attention by increasing the perception of information that potentially facilitates adverse behavior. Participants (N = 998) were assigned to one of three experimental conditions: reading an aggressive and emotional text asking them to stop eating meat (appeal condition); reading a neutral text about the nativeness and benefits of eating less meat (information condition); or completing an unrelated word count task (control condition). After assessing their reactance, participants were asked to identify as many words as possible in a word grid in which some words related to meat. Compared to the other conditions, the appeal condition elicited the greatest reactance. Furthermore, omnivore participants in this condition identified significantly more meat-related words when they reported higher levels of reactance. By showing that psychological reactance elicited by forceful health appeals increases attention to information that may facilitate the admonished behaviors, our findings contribute to an improved understanding of effective health communication. [ABSTRACT FROM AUTHOR]

The comprehensive model of information seeking (CMIS) is a well-known framework to predict health information seeking by a combination of health beliefs and medium-related factors. Despite being proposed almost three decades ago, few efforts have been made to systematically summarize CMIS scholarship. To fill this gap in the literature, 36 meta-analyses were first conducted to identify the bivariate relationships between variables in the CMIS. These meta-analytic data were then used to test path models evaluating the role of health beliefs and medium-related factors. The results showed that the models containing only factors related to the communication medium, only health factors, and a modified version of the CMIS fit the data relatively well. The original CMIS did not demonstrate an acceptable model fit. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Background: The success of the COVID-19 vaccination roll-out depended on clear policy communication and guidance to promote and facilitate vaccine uptake. The rapidly evolving pandemic circumstances led to many vaccine policy amendments. The impact of changing policy on effective vaccine communication and its influence in terms of societal response to vaccine promotion are underexplored; this qualitative research addresses that gap within the extant literature. Methods: Policy communicators and community leaders from urban and rural Ontario participated in semi-structured interviews (N = 29) to explore their experiences of COVID-19 vaccine policy communication. Thematic analysis was used to produce representative themes. Results: Analysis showed rapidly changing policy was a barrier to smooth communication and COVID-19 vaccine roll-out. Continual amendments had unintended consequences, stimulating confusion, disrupting community outreach efforts and interrupting vaccine implementation. Policy changes were most disruptive to logistical planning and community engagement work, including community outreach, communicating eligibility criteria, and providing translated vaccine information to diverse communities. Conclusions: Vaccine policy changes that allow for prioritized access can have the unintended consequence of limiting communities' access to information that supports decision making. Rapidly evolving circumstances require a balance between adjusting policy and maintaining simple, consistent public health messages that can readily be translated into action. Information access is a factor in health inequality that needs addressing alongside access to vaccines. [ABSTRACT FROM AUTHOR]

Dementia is currently one of the most significant public health challenges from a medical as well as a societal perspective. The number of people living with dementia is increasing, and there is conflicting evidence in terms of preventive measures and risk factors. The available therapies can slow down but neither stop nor reverse the condition. Educating the public about these circumstances is thus of utmost relevance. As the mass media are a major source of health-related information, this study uses a quantitative content analysis to examine the extent to which responsibility framing occurs concerning risk and protection factors for dementia. Besides the established levels of individual and society, this study considers the level "social network" as an independent level to account for the supporting role of relatives and friends in the care of people living with dementia. The results show that protection factors for dementia are reported more frequently than the risk factors of the condition. Further, attribution of responsibility for risk factors tended to be at the individual level, while protection was the responsibility of society and the social network. [ABSTRACT FROM AUTHOR]

The authors applaud the Surgeon General of the U.S. for launching an initiative to reduce health misinformation about electronic cigarettes (e-cigarettes). They talk about examples that continue to be propagated by the U.S. public health officials, issue that the CDC lacks, and the SG-sponsored public information website about e-cigarettes entitled "Know the Risks: E-cigarettes and Young People."

A major challenge in communicating health-related information is the involvement of multiple complex systems from the creation of the information to the sources and channels of dispersion to the information users themselves. To date, public health communications approaches have often not adequately accounted for the complexities of these systems to the degree necessary to have maximum impact. The virality of COVID-19 misinformation and disinformation has brought to light the need to consider these system complexities more extensively. Unaided, it is difficult for humans to see and fully understand complex systems. Luckily, there are a range of systems approaches and methods, such as systems mapping and systems modeling, that can help better elucidate complex systems. Using these methods to better characterize the various systems involved in communicating public health-related information can lead to the development of more tailored, precise, and proactive communications. Proceeding in an iterative manner to help design, implement, and adjust such communications strategies can increase impact and leave less opportunity for misinformation and disinformation to spread. [ABSTRACT FROM AUTHOR]

The recent COVID-19 outbreak has highlighted the importance of effective communication strategies to control the spread of the virus and debunk misinformation. By using accurate narratives, both online and offline, we can motivate communities to follow preventive measures and shape attitudes toward them. However, the abundance of misinformation stories can lead to vaccine hesitancy, obstructing the timely implementation of preventive measures, such as vaccination. Therefore, it is crucial to create appropriate and community-centered solutions based on regional data analysis to address mis/disinformation narratives and implement effective countermeasures specific to the particular geographic area. In this case study, we have attempted to create a research pipeline to analyze local narratives on social media, particularly Twitter, to identify misinformation spread locally, using the state of Pennsylvania as an example. Our proposed methodology pipeline identifies main communication trends and misinformation stories for the major cities and counties in southwestern PA, aiming to assist local health officials and public health specialists in instantly addressing pandemic communication issues, including misinformation narratives. Additionally, we investigated anti-vax actors' strategies in promoting harmful narratives. Our pipeline includes data collection, Twitter influencer analysis, Louvain clustering, BEND maneuver analysis, bot identification, and vaccine stance detection. Public health organizations and community-centered entities can implement this data-driven approach to health communication to inform their pandemic strategies. [ABSTRACT FROM AUTHOR]

In the current infodemic, how individuals receive information (channel), who it is coming from (source), and how it is framed can have an important effect on COVID-19 related mitigation behaviors. In light of these challenges presented by the infodemic, Dear Pandemic (DP) was created to directly address persistent questions related to COVID-19 and other health topics in the online environment. This is a qualitative analysis of 3806 questions that were submitted by DP readers to a question box on the Dear Pandemic website between August 30, 2020 and August 29, 2021. Analyses resulted in four themes: the need for clarification of other sources; lack of trust in information; recognition of possible misinformation; and questions on personal decision-making. Each theme reflects an unmet informational need of Dear Pandemic readers, which may be reflective of the broader informational gaps in our science communication efforts. This study highlights the role of an ad hoc risk communication platform in the current environment and uses questions submitted to the Dear Pandemic question box to identify informational needs of DP readers over the course of the COVID-19 pandemic. These findings may help clarify how organizations addressing health misinformation in the digital space can contribute to timely, responsive science communication and improve future communication efforts. [ABSTRACT FROM AUTHOR]

Trust and mistrust influence the utilization of health services, the quality of overall healthcare, and the prevalence of health disparities. Trust has significant bearing on how communities, and the individuals within them, perceive health information and recommendations. The People and Places Framework is utilized to answer what attributes of place threaten community trust in public health and medical recommendations. Augusta-Richmond County is ranked among the least healthy counties in Georgia despite being home to the best healthcare-to-residence ratios and a vast array of healthcare services. Semi-structured interviews were conducted with 31 neighborhood residents. Data were analyzed using the Sort & Sift, Think & Shift method. Threats to community trust were identified within four local-level attributes of place: availability of products and services, social structures, physical structures, and cultural and media messages. We found a broader web of services, policies, and institutions, beyond interactions with health care, that influence the trust placed in health officials and institutions. Participants spoke to both a potential lack of trust (e.g. needs not being met, as through lack of access to services) and mistrust (e.g. negative motives, such as profit seeking or experimentation). Across the four attributes of place, residents expressed opportunities to build trust. Our findings highlight the importance of examining trust at the community level, providing insight into an array of factors that impact trust at a local level, and extend the work on trust and its related constructs (e.g. mistrust). Implications for improving pandemic-related communication through community relationship building are presented. [ABSTRACT FROM AUTHOR]

COVID-19 vaccination has resulted in decreased hospitalization and mortality, particularly among those who have received a booster. As new effective pharmaceutical treatments are now available and requirements for non-pharmaceutical interventions (e.g. masking) are relaxed, perceptions of the risk and health consequences of SARS-CoV-2 infection have decreased, risking potential resurgence. This June 2022 cross-sectional comparative study of representative samples in New York City (NYC, n = 2500) and the United States (US, n = 1000) aimed to assess differences in reported vaccine acceptance as well as attitudes toward vaccination mandates and new COVID-19 information and treatments. NYC respondents reported higher COVID-19 vaccine acceptance and support for vaccine mandate than U.S. respondents, yet lower acceptance for the booster dose. Nearly one-third of both NYC and U.S. respondents reported paying less attention to COVID-19 vaccine information than a year earlier, suggesting health communicators may need innovation and creativity to reach those with waning attention to COVID-19-related information. [ABSTRACT FROM AUTHOR]

Various health and crisis studies have demonstrated support for the existence of knowledge gaps—a hypothesis suggesting that information will reach those in the lower socioeconomic status last, worsening health disparities. At the point at which COVID-19 vaccines were becoming widely accessible, the present study surveyed 651 Black Americans to understand vaccine hesitancy, intentions, and media learning variations after exposure to different types of social media posts about the COVID-19 vaccine. Although exposure to any of the message conditions in our study resulted in a decrease in vaccine hesitancy, we found mixed support for the knowledge gap hypothesis. Results show that lack of knowledge because of socioeconomic status is not a key factor driving vaccine hesitancy among Black Americans. Instead, public communication (government) campaigns may consider focusing on strategies to target Black American communities by age to improve media learning, and consider increasing social control and communal message functions to increase cognitive processing of pro-vaccine messages, and over the longer term, influence COVID-19 vaccine hesitancy and uptake. [ABSTRACT FROM AUTHOR]

Although public and private institutions have spent billions of dollars on COVID-19 vaccination campaigns, many of which claim to be "equity-focused," few articles to date have objectively described the landscape of these campaigns or identified existing gaps with a focus on those populations disproportionately impacted by the virus. To these ends, a high-level landscape analysis of COVID-related communication campaigns was conducted. Analysis of 15 COVID-related communication campaigns based on six criteria (i.e., understandability, accessibility, actionability, credibility/trustworthiness, relevance/relatability, and timeliness) identified successful efforts, including campaigns aligned with the World Health Organization's Strategic Communications Framework and rooted in community co-design and communication science. The analysis also revealed five common shortcomings: campaigns were not end-user focused, only "checked the box" when communicating with historically under-resourced communities, were largely broadcast-focused and rarely involved two-way engagement strategies or tactics, demonstrated poor use of online communication approaches and failed to moderate campaign comment boards/social media sites, and commonly targeted "intermediary" audiences with materials that were not "end user ready." Based on these findings, the authors offer recommendations to guide funding and development of future health communication campaigns focused on reaching diverse audiences. [ABSTRACT FROM AUTHOR]

This methods commentary focuses on lessons learned from working with community data collectors on a refugee health disparities study during the COVID-19 pandemic. While there is a strong literature base for community health workers in refugee or migrant communities, there is less known about the procedural elements, challenges, and effectiveness of using community data collectors (CDCs) in research with refugee or migrant communities. Recognizing the cultural wealth and unique strengths of local stakeholders in the refugee community, the research team employed a robust collaborative approach by partnering with CDCs to design and administer the Telehealth and COVID-19 Knowledge, Attitudes, and Practices in New York Refugee Communities Survey. The study's success was largely due to the CDC partnership. This methods commentary highlights the utility of Community-Based Participatory Research as a culturally-responsive framework well-suited to exploring health disparities as part of a broader agenda of public health communication research. [ABSTRACT FROM AUTHOR]