Confronting Health Misinformation Surrounding COVID-19 Vaccines in the State of Florida.

COVID-19 vaccination is estimated to have averted more than 2.4 million deaths globally. In the United States (U.S.) alone, more than 120,000 deaths and 700,000 hospitalizations are reportedly estimated to have been prevented during the first six months of the vaccine campaign. Despite the overwhelming evidence regarding the safety and efficacy of vaccination, COVID-19 vaccine hesitancy continues to pose a significant threat to public health. Notably, an unexpected source of vaccine misinformation has been the Surgeon General of the State of Florida, Dr. Joseph Ladapo. While both a tenured faculty member of the University of Florida, College of Medicine and the Surgeon General of Florida, Dr. Ladapo has delivered official Florida Department of Health statements regarding COVID-19 vaccines that run contrary to those of the U.S. Centers for Disease Control and Prevention (CDC). While tenure is designed to protect those with contrarian views, we believe that the University has an ethical obligation to condemn misleading statements that put public health at risk. Herein, we explore the challenges of managing misinformation disseminated by someone who is simultaneously a tenured professor at a public, state-supported university, and a politically appointed public health official.

A scoping review of wildfire smoke risk communications: issues, gaps, and recommendations.

BACKGROUND: Wildfire smoke exposure has become a growing public health concern, as megafires and fires at the wildland urban interface increase in incidence and severity. Smoke contains many pollutants that negatively impact health and is linked to a number of health complications and chronic diseases. Communicating effectively with the public, especially at-risk populations, to reduce their exposure to this environmental pollutant has become a public health priority. Although wildfire smoke risk communication research has also increased in the past decade, best practice guidance is limited, and most health communications do not adhere to health literacy principles: readability, accessibility, and actionability. This scoping review identifies peer-reviewed studies about wildfire smoke risk communications to identify gaps in research and evaluation of communications and programs that seek to educate the public. METHODS: Four hundred fifty-one articles were identified from Web of Science and PubMed databases. After screening, 21 articles were included in the final sample for the abstraction process and qualitative thematic analysis. Ten articles were based in the US, with the other half in Australia, Canada, Italy, and other countries. Fifteen articles examined communication materials and messaging recommendations. Eight papers described communication delivery strategies. Eleven articles discussed behavior change. Six articles touched on risk communications for vulnerable populations; findings were limited and called for increasing awareness and prioritizing risk communications for at-risk populations. RESULTS: This scoping review found limited studies describing behavior change to reduce wildfire smoke exposure, characteristics of effective communication materials and messaging, and communication delivery strategies. Literature on risk communications, dissemination, and behavior change for vulnerable populations was even more limited. CONCLUSIONS: Recommendations include providing risk communications that are easy-to-understand and adapted to specific needs of at-risk groups. Communications should provide a limited number of messages that include specific actions for avoiding smoke exposure. Effective communications should use mixed media formats and a wide variety of dissemination strategies. There is a pressing need for more intervention research and effectiveness evaluation of risk communications about wildfire smoke exposure, and more development and dissemination of risk communications for both the general public and vulnerable populations.

Instagram for audience engagement: an evaluation of CERC framework in the GCC nations for digital public health during the Covid-19 pandemic.

BACKGROUND: In this study, we investigate the utilization of Instagram by public health ministries across the Gulf Cooperation Council (GCC) nations to disseminate health-related information during the COVID-19 pandemic. With Instagram's visual-centric approach and high user engagement, the research aims to investigate its critical yet complex role in information dissemination amid a health crisis. METHODS: To examine how Instagram communication strategies align with the CDC's Crisis and Emergency Risk Communication (CERC) framework, we employ the content analysis method. This approach helps to evaluate the effectiveness and challenges of employing Instagram for health communication within a region known for its significant social media usage. RESULTS: Findings indicate that Instagram serves as a vital platform for the rapid dissemination of health information in the GCC, leveraging its visual capabilities and wide reach. The GCC ministries of health utilized Instagram to demonstrate a consistent and strategic approach to communicate essential COVID-19 related information. Kuwait and Bahrain were the most active of all the assessed ministries with respect to the number of engagement metrics (likes and comments). Most of the posts, as per the CERC framework, were informational and related to vaccine infection and death cases. The second most salient theme in line with the CERC framework was about promoting actions, followed by Instagram posts about activities, events, and campaigns. CONCLUSIONS: The research underscores Instagram's potential as a powerful tool in enhancing public health resilience and responsiveness during health emergencies in the GCC. It suggests that leveraging social media, with careful consideration of its affordances, can contribute significantly to effective health communication strategies in times of crisis.

From Theory to Practice: Mitigating the Harm of Online Harassment in Public Health.

This article uses the theoretical framework of the networked public to understand the dynamics of online harassment of public health professionals. Coauthors draw on their experiences with health communication on social media, in a local public health department, and in news media to illustrate the utility of this framework. Their stories also highlight the need to build a more proactive approach to online harassment in public health. The coauthors highlight recommendations that health communicators can take in the face of online harassment. We also call for a more coordinated community effort to create supportive environments for online health communication, including increased funding of local health departments and increased regulation of social media companies.

Scaling the Idea of Opinion Leadership to Address Health Misinformation: The Case for "Health Communication AI".

There is strong evidence of the impact of opinion leaders in health promotion programs. Early work by Burke-Garcia suggests that social media influencers are the opinion leaders of the digital age as they come from the communities they influence, have built trust with them, and may be useful in combating misinformation by disseminating credible and timely health information and prompting consideration of health behaviors. AI has contributed to the spread of misinformation, but it can also be a vital part of the solution, informing and educating in real time and at scale. Personalized, empathetic messaging is crucial, though, and research supports that individuals are drawn to empathetic AI responses and prefer them to human responses in some digital environments. This mimics what we know about influencers and how they approach communicating with their followers. Blending what we know about social media influencers as opinion leaders with the power and scale of AI can enable us to address the spread of misinformation. This paper reviews the knowledge base and proposes the development of something we term "Health Communication AI" - perhaps the newest form of opinion leader - to fight health misinformation.

A scientific theory of gist communication and misinformation resistance, with implications for health, education, and policy.

A framework is presented for understanding how misinformation shapes decision-making, which has cognitive representations of gist at its core. I discuss how the framework goes beyond prior work, and how it can be implemented so that valid scientific messages are more likely to be effective, remembered, and shared through social media, while misinformation is resisted. The distinction between mental representations of the rote facts of a message-its verbatim representation-and its gist explains several paradoxes, including the frequent disconnect between knowing facts and, yet, making decisions that seem contrary to those facts. Decision makers can falsely remember the gist as seen or heard even when they remember verbatim facts. Indeed, misinformation can be more compelling than information when it provides an interpretation of reality that makes better sense than the facts. Consequently, for many issues, scientific information and misinformation are in a battle for the gist. A fuzzy-processing preference for simple gist explains expectations for antibiotics, the spread of misinformation about vaccination, and responses to messages about global warming, nuclear proliferation, and natural disasters. The gist, which reflects knowledge and experience, induces emotions and brings to mind social values. However, changing mental representations is not sufficient by itself; gist representations must be connected to values. The policy choice is not simply between constraining behavior or persuasion-there is another option. Science communication needs to shift from an emphasis on disseminating rote facts to achieving insight, retaining its integrity but without shying away from emotions and values.

Climate Communication, Public Health, and Social Media: Examining the Role of Health Agencies in Addressing the Impacts of Climate Change on Human Health.

The impacts of climate change on human health are a critical public health concern, with previous studies highlighting its clear effects on well-being. Understanding how state and territorial health agencies (STHAs) are addressing these emerging risks is important. This study conducted 26 in-depth interviews across the U.S. to explore the perceptions and communication strategies of STHA officials regarding climate change's impact on human health. Additionally, the study sought to identify the primary challenges faced by these officials to effectively communicate the impacts. Thematic analysis of the data revealed three major themes: community building and coalitions, climate denialism on social media, and misinformation about climate change and its effects on human health. These findings offer valuable insights for climate change and public health communication. The importance of the STHAs' development of technical and informational capacity to effectively communicate climate-related risks and threats is emphasized.

Reconsidering the Effectiveness of Fear Appeals: An Experimental Study of Interactive Fear Messaging to Promote Positive Actions on Climate Change.

Masspersonal communication has emerged as a compelling alternative persuasive approach in response to the widespread use of social media. It is crucial to comprehend how observing online interpersonal interactions regarding the fear appeal of climate change can foster pro-environmental behaviors among users. This study examines the effects of vicarious message interactivity in promoting actions against climate change and the underlying mechanisms behind this effect. The results of an online experiment conducted in China (N = 236) revealed that psychological reactance and message elaboration mediated the effects of vicarious message interactivity on behavioral intention in a serial indirect effect. In comparison to static fear appeal, interactive fear appeal proves effective in reducing psychological reactance, promoting message elaboration, and ultimately increasing intention to take actions against climate change. Our findings not only contribute to the literature on interactive communication but also provide insights for environmental-health campaigns on social media.

How Do Behavioral Framing, Linguistic Certainty, and Target Specification Impact Responses to Vaping Prevention Messages?

While research on youth vaping prevention has begun to grow, little work has examined language choice in vaping prevention messages. This study examined adolescents' responses to vaping prevention statements that varied on three features: behavioral framing, linguistic certainty, and target specification. We conducted a 2 (behavioral framing) by 2 (linguistic certainty) by 2 (target specification) by 3 (risk type) plus control condition between-subjects experiment using a national probability sample. Adolescents (N = 1,603) were randomly assigned to one of 25 conditions in which they viewed a vaping prevention statement (or a control statement about vape litter) followed by measures of perceived message effectiveness (PME), perceived severity and susceptibility of vaping risks, message trustworthiness, message relevance, and intentions to seek more information about vaping risks. Results showed main effects of behavioral framing, such that a declarative frame ("Vaping can … ") led to higher PME, higher perceived severity, and greater information seeking intentions than a contingent frame ("If you vape, it can…"), while an interaction revealed that most declarative frame effects were driven by adolescents who were susceptible to vaping. There were also main effects of linguistic certainty, such that the word "can" ("Vaping can … ") led to higher PME, higher perceived susceptibility and severity, and greater information seeking intentions than the word "could" ("Vaping could … "). No main effect of target specification ("you" vs. "teens") was observed. Overall, findings suggest that vaping prevention messages that communicate greater certainty have greater behavior change potential.

How Do Gain-Loss Frames and Cultural Arguments Persuade? Designing Effective Messages to Weaken College Students' Binge-Drinking Intentions.

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.

An Exploratory Content Analysis of the Use of Health Communication Strategies and Presence of Objectification in Fitness Influencer Social Media Posts.

Health and fitness content intended to inspire people to live healthy lives (e.g. "fitspiration") has been linked to negative body image among girls and young women. Fitness influencers purport wanting to motivate healthy behaviors. This study seeks to examine the presence of strategies known to positively influence health behaviors (e.g. attitudes, self-efficacy) as well as of content known to have a negative influence (e.g. objectification) among fitness influencers. We conducted a content analysis (N = 441) of a random sample of one year of posts from four Instagram fitness influencers popular with girls and young women in the United States. The main analysis consisted of codes related to objectification, health promotion strategies, health-related content, and social engagement (i.e., likes). We found that fitness influencers included content that conveyed constructs previously found to positively influence health behaviors (e.g., attitudes and self-efficacy), but objectification was frequently present, in more than half of the posts. Additionally, we found that the presence of objectification in posts was negatively associated with likes, a form of social endorsement. We suggest health communicators aim to work in tandem with fitness influencers to include content that may motivate positive health behaviors and improve media literacy and that influencers aim to reduce the amount of objectifying content included in their posts. Our findings shed light on content being conveyed and possible insights into the negative effects associated with viewing such content.

Sourcing UK COVID-19 News: An Analysis of Sourcing Patterns of 15 UK News Outlets Reporting on COVID-19 Across Facebook, Twitter, and Instagram.

How a health emergency is defined and presented through the news media matters for public understanding and health outcomes. Previous studies have endeavored to identify the patterns of news sourcing in crisis coverage, specifically the interplay between political sources and health expert sources, but yielded inconclusive results. This study analyses the types and roles of actors (those entities mentioned in a story) and sources cited in news coverage of COVID-19 by surveying social media posts published by 15 UK news outlets coverage across Facebook, Twitter, and Instagram between 1 January to December 31 2020. Overall, the findings show the prominence of political sources in UK news and that the most frequently named sources were representatives of the UK government. Moreover, when stories involved political actors, they were more likely to be given a voice as a source. This demonstrates how COVID-19 was a generalized crisis for the UK, which cascaded beyond health and into other economic, social, and cultural domains. The data show some variations in sourcing patterns between the different social media platforms. The analysis suggests that this may reflect the conventions of presenting news on each platform, with some tending toward the model of consensus by prioritizing political and government sources, and others contributing to a sphere of legitimate controversy by giving voice to a wider range of sources. This is distinctive and opens up the possibility for further research on how journalists adapt stories for social media and the consequences for public health communication.

Can extended health communication improve newly settled refugees' health literacy? A quasi-experimental study from Sweden.

Structural and contextual factors such as limited work and housing opportunities negatively affect the health and well-being of newly settled refugee migrants in receiving high-income countries. Health promotion initiatives aiming at strengthening health and integration have been tried out within the Swedish Introduction program for refugee migrants. However, longitudinal evaluations of these interventions are rare. The aim of the current study was to compare the effectiveness of a regular and an extended civic orientation course with added health communication and examine whether the latter would improve self-rated health and psychological well-being, health literacy and social capital among newly settled refugee migrants in Sweden. Pre- and post-assessment questionnaires were collected from the intervention group receiving the extended course (n = 143) and a control group receiving the regular course (n = 173). Linear mixed models and chi-square analyses showed a significant increase with a small effect size (0.21) in health literacy in the intervention group. However, there were no significant changes in emotional and practical support, general self-rated health or psychological well-being. The findings indicate that added health communication provided embedded in the civic orientation course can increase health literacy. However, further longitudinal studies are needed to confirm the sustainability of the observed effect and examine whether these short-term improvements in health literacy translate to long-term advances in health and integration.

(Dis)harmony in times of crisis? An analysis of COVID-related strategic communication by Swiss public health institutions.

OBJECTIVES: This study aims to assess COVID-related communication by Swiss public health institutions (PHI) as well as the challenges they faced in implementing their communication strategies. STUDY DESIGN: This study uses a two-part mixed methods design, combining automated content analysis of press releases by PHI and semi-structured interviews with PHI communication experts. METHODS: The automated content analysis uses natural language processing techniques to measure semantic themes and linguistic properties of 1882 press releases from national and regional PHI during the first year of the COVID-19 pandemic. The semi-structured interviews with 25 communication experts from key PHI explore the challenges faced in implementing their communication strategies. RESULTS: The content analysis reveals key themes in press releases, including non-pharmaceutical interventions, quarantine, testing, contact tracing, hospital situations, and the pandemic's impact on the economy. The linguistic measures indicated a decrease in complexity and readability over time, with no significant differences between national and regional PHI. Interviews revealed challenges arising from organizational structures, the multi-systemic nature of the pandemic, and from expectations of the public. CONCLUSIONS: The study highlights the importance of agility in public health communication and the need for efficient coordination within and between PHI. Organizational structures should be adapted to allow for more agile modes of operation during crises. Policymakers should clarify roles and responsibilities of different actors in public health frameworks to ensure streamlined communication. Understanding the communication efforts and challenges faced by PHI during the pandemic helps preparing for future health crises and improve public health communication practices.

Formative Research to Inform College Health Communication Campaigns About COVID-19 Prevention Behaviors.

This research aimed to inform the development of a health communication campaign to increase the uptake of COVID-19 prevention behaviors among university students. Twenty-eight students attending a mid-sized public university in the southeastern United States and 84 parents or guardians of university students were recruited. The study included an online survey assessing COVID-19 prevention behaviors, perceived susceptibility to COVID-19, perceived severity of COVID-19, and semi-structured interviews to elicit beliefs on COVID-19 prevention behaviors. Students and parents/guardians reported that getting COVID-19 was possible but not necessarily likely. COVID-19 was seen as serious and at least somewhat severe. Dominant interview themes for benefits, barriers, response efficacy, and self-efficacy related to prevention behaviors are reported. Overall, perceptions of behavioral benefits, barriers, and response efficacy were often shared by parents and students but varied across behaviors. These data provide insights for future campaign development for the control of infectious diseases among college students.

Experiences of primary health care nurses regarding the promotion of sexual reproductive health communication with grandparents in Tshwane District, Gauteng Province.

A qualitative, descriptive contextual design study was conducted to explore and describe the experiences of primary health care nurses regarding the promotion of sexual reproductive health communication with grandparents in Tshwane District, Gauteng Province. A non-probability, purposive sampling was used to select 12 Primary Health care nurses based in the Primary health care facilities within Tshwane District. An in-depth interview was used to collect data and Giorgio's five (5) steps were followed during data analysis. Ethical consideration was adhered to by ensuring confidentiality, anonymity, and privacy. All participants signed the consent form to indicate their willingness to participate in the study. Findings of the study revealed the following themes: Primary health care nurses (PHCNs) experiences of sexual and reproductive health communication, and PHCNs experiences of factors facilitating sexual reproductive health (SRH) communication. From the findings it can then be concluded that PHCNs understand facilitating factors to promote open communication with grandparents regarding SRH.

Une étude contextuelle qualitative et descriptive a été menée pour explorer et décrire les expériences des infirmières de soins de santé primaires concernant la promotion de la communication sur la santé sexuelle et reproductive avec les grands-parents dans le district de Tshwane, province de Gauteng. Un échantillonnage non probabiliste et raisonné a été utilisé pour sélectionner 12 infirmières de soins de santé primaires basées dans les établissements de soins de santé primaires du district de Tshwane. Un entretien approfondi a été utilisé pour collecter les données et les cinq (5) étapes de Giorgio ont été suivies lors de l'analyse des données. Des considérations éthiques ont été respectées en garantissant la confidentialité, l'anonymat et la vie privée. Tous les participants ont signé le formulaire de consentement pour indiquer leur volonté de participer à l'étude. Les résultats de l'étude ont révélé les thèmes suivants : les expériences des infirmières de soins de santé primaires (PHCN) en matière de communication sur la santé sexuelle et reproductive, et les expériences des PHCN sur les facteurs facilitant la communication sur la santé sexuelle et reproductive (SSR). À partir des résultats, on peut alors conclure que les PHCN comprennent les facteurs facilitant la promotion d'une communication ouverte avec les grands-parents concernant la SSR.

Mapping breastfeeding and COVID-19 related content and engagement on Facebook: Results from an online social listening study.

ISSUE ADDRESSED: The COVID-19 pandemic has seen evidence and advice evolve quickly. Since the start of the pandemic there has been confusion and concern about breastfeeding and COVID-19, and advice for this group has at times been contradictory. The volume of information on social media has exacerbated this. This study aimed to understand breastfeeding-related COVID-19 information sharing on social media during the global and Australian vaccine roll-out. METHODS: The CrowdTangle platform was used to source data from December 2020 to December 2021. Posts were categorised to intent and source and mapped to a timeline of pandemic-related events and announcements. Descriptive analysis was used to understand data distribution patterns and qualitative analysis for post-intent. RESULTS: A total of 945 posts were included. Post-interactions ranged from 0 to 6500. Vaccine-related posts were the highest in number and increased over time. Non-profit organisations shared the highest number of posts (n = 241), but interactions were highest with personal and government accounts. Peaks in posts and interactions mapped to key pandemic-related announcements and events. CONCLUSION: These results describe the breastfeeding and COVID-19 related content shared on Facebook over 13 months, and the associated interactions. Breastfeeding is an important public health issue and breastfeeding women have experienced conflicting and confusing breastfeeding-related information during the COVID-19 pandemic. Better understanding of social media usage, and the monitoring of changes in usage, as an emergency unfolds, can help target communications. This article adds to the evidence in understanding user reactions to COVID-19 related breastfeeding information on social media. SO WHAT?: Social listening is an important part of health communication and infodemic management. Understanding how users react to and engage with COVID-19 related breastfeeding information on social media can help to understand how the general public perceives and responds to health advice and other information being shared.

[Information on health promotion and prevention on the websites of Baden-Württemberg's public health services-a first approach]. / Informationen zu Gesundheitsförderung und Prävention auf den Webseiten baden-württembergischer Gesundheitsämter ­ eine erste Annäherung.

BACKGROUND: Health promotion and prevention are core tasks of German public health services (Öffentlicher Gesundheitsdienst). Health communication is, among other things, central to their effectiveness. As the Internet has become an important source of health information and public health services are increasingly in the public eye, their websites are gaining more focus. We therefore investigated how public health services present topics on health promotion and prevention of non-communicable diseases (HPP-NCDs) on their websites. METHODS: The websites of the 38 public health service departments in Baden-Wuerttemberg were examined using qualitative content analysis from June to October 2022. The presentation of the HPP-NCDs topic on the websites as well as the relevant measures were documented. For each measure/activity the addressed target group, the topic, and the type of intervention was collected. RESULTS: The HPP-NCDs topic is addressed on all websites (n = 38); however, the presentation style is heterogeneous. A total of 243 HPP-NCDs measures/activities were identified across the 38 websites. There was a broad spectrum of topics, target groups, and types of intervention used in the measures/activities presented. DISCUSSION: The study shows an extensive but heterogeneous presentation of HPP-NCDs on the websites of public health services. In doing so, they are caught between the requirements of public relations and health information. The use of synergy effects through the joint promotion of nationally relevant informational materials and measures could be beneficial for public health services.

A qualitative assessment of barriers to healthcare and HIV prevention services among men who have sex with men in non-metropolitan areas of the south.

HIV cases are increasing in the rural Southern United States, especially among men who have sex with men (MSM). To facilitate healthcare access and encourage HIV prevention for non-metropolitan MSM, it is essential to examine their barriers to care. This qualitative study conducted semi-structured interviews with 20 MSM living in non-metropolitan areas of the South. Analysis revealed that MSM experience multiple barriers accessing healthcare in non-metropolitan areas such as finding knowledgeable and affirming providers with desired characteristics and beliefs and communicating with providers about sexual health and HIV prevention. To aid in identification, many respondents expressed a desire for providers to publicly signal that they provide care for sexual and gender minority patients and are an inclusive clinical space. Overall, results suggest that MSM face unique healthcare-related challenges, beyond those typically experienced by the broader population in non-metropolitan areas, because of tailored identity-based needs. To better support MSM in non-metropolitan areas, especially in the South where increased experiences of stigma are found, providers should seek further training regarding sexual health communication and HIV prevention, indicate on websites and in offices that they support sexual and gender minority patients, and provide telehealth services to MSM living in more geographically isolated areas.