Boil water notices as health-risk communication: risk perceptions, efficacy, and compliance during winter storm Uri.

Winter Storm Uri was a disaster that impacted much of the United States during February of 2021. During and after the storm, Texas and Oklahoma experienced massive power grid failures. This led to cascading impacts, including water system disruptions and many boil water notices (BWNs). The breakdown of some communication channels and the inability to enact protective actions due to power outages, as well as travel limitations on public roads, complicated the dissemination and implementation of notifications. This research examined individuals' perceptions of risk, water quality, and BWNs during Uri. Additionally, this study sought to understand if previous experience with a BWN influenced compliance during Uri and how perceived efficacy impacted these variables. Surveying 893 Texans and Oklahomans revealed that most Uri-affected respondents believed the risks associated with BWNs were severe. Income and race were two factors that influenced BWN compliance. Age, gender, and level of education did not influence compliance. Previous experience with BWNs did not increase risk perceptions. Higher levels of perceived efficacy correlated to higher levels of compliance, perceptions of risk, and water quality, much of which support propositions of the Extended Parallel Process Model. Results suggest that pre-disaster planning and communication are imperative to helping reduce risk(s) and enhancing efficacy during a disaster, especially for novel disasters that have cascading risks, like Winter Storm Uri.

Attitudes and Misconceptions of Coronavirus Disease and Vaccination Among African Americans in Rural Mississippi.

Despite the recommendations for COVID-19 preventive health behaviors, it continues to increase alarmingly. This study examined how media coverage, myths, political leaders, and community leaders influence the attitudes and misconceptions about COVID-19 and COVID-19 vaccination uptake in the Mississippi Delta region. This qualitative study employed focus group discussions (FDGs) with representatives from three rural counties in the Mississippi Delta. A thematic analysis approach was used for data analysis. Participants were aware of how COVID-19 is transmitted, the preventative measures that can be used to mitigate the spread of the virus, and misconceptions and beliefs that lingered in their communities. Participants were uncertain about the need for the COVID-19 vaccine in terms of perceived risks (e.g., side effects, efficacy, and safety) and its novelty. Participants also discussed a wide range of COVID-19 misinformation that resulted in distress and distrust of the vaccine and health behavior recommendations. There are varying misconceptions and beliefs about COVID-19 and COVID-19 vaccine among communities in the rural Mississippi Delta. Thus, multi-sectoral collaborations between agencies that can use risk communication frameworks to deliver accurate health information that can resolve misinformation about COVID-19 in rural communities are needed.

PRISM and Emotions: Understanding the Role of Fear and Hope toward Vaccine Information Seeking Intentions.

Vaccines represent one of the greatest health efforts to help combat diseases, yet they often evoke emotional responses among individuals. These emotional responses can influence an individual's desire to seek information about vaccines. The purpose of this research was to examine these relationships further using the Planned Risk Information Seeking Model (PRISM) and explore the role of emotions, specifically fear and hope, on vaccine-related information seeking intentions. Two separate models were tested using the PRISM model, one for fear and one for hope. Results suggest fear did not have a significant direct effect on vaccine information seeking, while hope had a positive and significant relationship. Interestingly, both attitude toward seeking and perceived current knowledge each had a positive relationship with information seeking intentions in the fear and hope models. Future research should continue to examine the role of specific emotions within the PRISM model to better predict information seeking intentions.

Boil Water Advisories as Risk Communication: Consistency between CDC Guidelines and Local News Media Articles.

The Safe Drinking Water Act Public Notification Rule requires that customers of public water systems (PWS) be informed of problems that may pose a risk to public health. Boil water advisories (BWA) are a form of communication intended to mitigate potential health risks. The Centers for Disease Control and Prevention (CDC) developed guidance for BWAs. We examined how local US news media incorporate the CDC's guidelines when reporting on BWAs. A content analysis of 1040 local news media articles shows these reports did not consistently incorporate CDC guidelines. Overall, 89% of the articles communicated enough information for readers to determine if they were included in the impacted area. Articles that included at least some of the CDC's instructions for boiling water were likely (p < .001) to include other risk information, such as the functions for which water should be boiled (e.g., drinking, brushing teeth) and that bottled water could be used as an alternative source. However, this information was included in only 47% of the articles evaluated. Results suggest public notifications often do not serve the public need for clear risk communication.

Trust and Public Health Emergency Events: A Mixed-Methods Systematic Review.

The systematic review examined the phenomenon of trust during public health emergency events. The literature reviewed was field studies done with people directly affected or likely to be affected by such events and included quantitative, qualitative, mixed-method, and case study primary studies in English (N = 38) as well as Arabic, Chinese, French, Russian, and Spanish (all non-English N = 30). Studies were mostly from high- and middle-income countries, and the event most covered was infectious disease. Findings from individual studies were first synthesized within methods and evaluated for certainty/confidence, and then synthesized across methods. The final set of 11 findings synthesized across methods identified a set of activities for enhancing trust and showed that it is a multi-faceted and dynamic concept.

Sex Differences in Hierarchical Stability in a Formation of a Mixed-sex Group of Rhesus Macaques.

Forming groups of captive rhesus macaques (Macaca mulatta) is a common management practice. New formations of unfamiliar macaques can be costly, with high levels of trauma, particularly as intense aggression is used to establish a dominance hierarchy. Combining previous subgroups into one new group may be beneficial, as some individuals already have established dominance relationships. We tested this hypothesis by forming a new mixed-sex group of rhesus macaques that combined an established group of females with an established group of males. Prior to the mixed-sex group formation, both the female and male hierarchies had been stable for 3 y; after mixed-sex group formation these hierarchies were maintained by the females and were initially maintained by the males for 3 wks. However, the temporary hospitalization (due to a laceration caused by aggression) of the alpha male destabilized the male hierarchy. Age and weight then predicted male rank. Temporary hospitalizations resulted in rank changes for the males, evidenced by reversals in subordination signals. This study indicates that using established groups of familiar individuals may maintain female hierarchical stability in a mixedsex group formation, but further research is needed to understand how to maintain and predict male hierarchical stability to reduce trauma. Improved knowledge of hierarchical stability would be invaluable to managers of large rhesus macaque groups and would help improve the welfare of captive rhesus macaques.

Informational Sources, Social Media Use, and Race in Flint, Michigan's Water Crisis.

Safe, clean water is necessary for health and wellbeing. Water issues affect minority and vulnerable populations at disproportionate rates, including the poor and racial and ethnic minorities. An investigation of the relationships of race, social media use, and informational sources during the municipal water crisis in Flint, Michigan reflects an instrumental view of communication and uses and gratifications theory in this study. Data from 208 Flint residents in 2016 indicated that African American respondents favored interpersonal networks and resources and were more likely than other racial groups to obtain current information about the water crisis via Instagram. Preferred channels and sources to receive additional crisis information varied on the basis of race.

Health-Related Disaster Communication and Social Media: Mixed-Method Systematic Review.

This mixed-method evidence synthesis drew on Cochrane methods and principles to systematically review literature published between 2003 and 2016 on the best social media practices to promote health protection and dispel misinformation during disasters. Seventy-nine studies employing quantitative, qualitative, and mixed methods on risk communication during disasters in all UN-languages were reviewed, finding that agencies need to contextualize the use of social media for particular populations and crises. Social media are tools that still have not become routine practices in many governmental agencies regarding public health in the countries studied. Social media, especially Twitter and Facebook (and equivalents in countries such as China), need to be incorporated into daily operations of governmental agencies and implementing partners to build familiarity with them before health-related crises happen. This was especially observed in U.S. agencies, local government, and first responders but also for city governments and school administrations in Europe. For those that do use social media during health-related risk communication, studies find that public relations officers, governmental agencies, and the general public have used social media successfully to spread truthful information and to verify information to dispel rumors during disasters. Few studies focused on the recovery and preparation phases and on countries in the Southern hemisphere, except for Australia. The vast majority of studies did not analyze the demographics of social media users beyond their geographic location, their status of being inside/outside the disaster zone; and their frequency and content of posting. Socioeconomic demographics were not collected and/or analyzed to drill deeper into the implications of using social media to reach vulnerable populations. Who exactly is reached via social media campaigns and who needs to be reached with other means has remained an understudied area.

Grade-IV inferior glenohumeral mobilization does not immediately alter shoulder and scapular muscle activity: a repeated-measures study in asymptomatic individuals.

OBJECTIVES: To assess: (1) the presence of any carry-over effect between interventions; (2) the immediate effects of inferior shoulder mobilization on shoulder and scapular muscle activity; and (3) to compare muscle activity response between the control and mobilization conditions. Repeated measures, cross-over, pre-post intervention study with sample of convenience. METHODS: Twenty-two asymptomatic individuals performed 10 repetitions of shoulder abduction before and after the control and mobilization, with a dosage of three sets of 30-s duration, with grade-IV. The order of intervention was randomized. Surface electromyography was used for recording activity of upper and lower trapezius; anterior, middle and posterior deltoids; supraspinatus; infraspinatus; and serratus anterior. Repeated measures mixed-model analysis of variance was used to assess immediate changes in muscle activity levels following inferior shoulder mobilization. Statistical parametric mapping (SPM) was used for comparing muscle activity waveforms between control and mobilization conditions throughout the range of motion. RESULTS: No systematic changes in muscle activity levels were found between: (1) baseline and follow-up for each condition, at the concentric and eccentric phases of shoulder abduction; (2) control and mobilization conditions during the concentric and eccentric phases of shoulder abduction. SPM results suggested no differences in muscle activity pattern between conditions. CONCLUSIONS: Inferior shoulder mobilization did not produce immediate effects on shoulder and scapular muscle activity. It is possible that the dose used was insufficient to generate an immediate neuromuscular response to the mobilization.