Beliefs in COVID-19 Vaccine Misinformation Among Unvaccinated Black Americans: Prevalence, Socio-Psychological Predictors, and Consequences.

Health-related misinformation is a major threat to public health and particularly worrisome for populations experiencing health disparities. This study sets out to examine the prevalence, socio-psychological predictors, and consequences of beliefs in COVID-19 vaccine misinformation among unvaccinated Black Americans. We conducted an online national survey with Black Americans who had not been vaccinated against COVID-19 (N = 800) between February and March 2021. Results showed that beliefs in COVID-19 vaccine misinformation were prevalent among unvaccinated Black Americans with 13-19% of participants agreeing or strongly agreeing with various false claims about COVID-19 vaccines and 35-55% unsure about the veracity of these claims. Conservative ideology, conspiracy thinking mind-set, religiosity, and racial consciousness in health care settings predicted greater beliefs in COVID-19 vaccine misinformation, which were associated with lower vaccine confidence and acceptance. Theoretical and practical implications of the findings are discussed.

Persuasive Effects of Temporal Framing in Health Messaging: A Meta-Analysis.

This meta-analysis investigated the persuasive effects of temporal framing in health messaging. Our analysis included 39 message pairs from 22 studies in 20 articles (N = 4,998) that examined the effects of temporal framing (i.e. present-oriented messages vs. future-oriented messages) on attitudes, intentions, and behaviors in health contexts. We found that present-oriented messages were significantly more persuasive than future-oriented messages in terms of intentions and integrated persuasive outcomes. Effects of temporal framing on attitudes and behaviors were not statistically significant. We tested six moderators of temporal framing effects (gain vs. loss framing, temporal framing operationalization, behavior type, timing of effect assessment, age, CFC levels) but none of them was statistically significant. Implications for future temporal framing research are discussed.

Motivating COVID-19 Vaccination through Persuasive Communication: A Systematic Review of Randomized Controlled Trials.

Vaccination is a vital defense against COVID-19 infections and outbreaks, yet vaccine hesitancy poses a significant threat to pandemic response and recovery. We conducted a systematic review of published randomized controlled trials (N = 47) assessing the persuasive effects of COVID-19 communication on COVID-19 vaccine acceptance. Individual vs. collective appeals and gain vs. loss frames are among the most frequently assessed message features, but they generally do not make a difference in persuasion. Normative messages that highlight higher (vs. lower) prevalence of vaccine acceptance are more persuasive. Message sources overall have limited impact on COVID-19 vaccine acceptance, but sources that have a shared identity with the message receivers tend to be persuasive. More engaging message channels such as interactive chatbots and videos are promising communication tools but are generally under-utilized and under-studied. Compared to no communication or irrelevant communication, COVID-19 vaccine messages generally have a small advantage in increasing COVID-19 vaccine acceptance. Messages that include 1) vaccine safety and/or efficacy information; 2) collective appeals combined with embarrassment appeals; and 3) political leaders' vaccine endorsement are among the most effective messaging strategies. There is no evidence of any backfire effects of COVID-19 vaccine messages. We discuss the implications of our findings for persuasive message design in pandemic vaccine communication.

Understanding the psychological antecedents of COVID-19 vaccine acceptance among Black Americans: implications for vaccine communication.

BACKGROUND: Guided by the 5C (confidence, complacency, constraints, calculation, and collective responsibility) model of vaccination behavior, we examine the psychological antecedents of COVID-19 vaccine acceptance (i.e. attitudes and intentions toward COVID-19 vaccination) among Black Americans, a group disproportionately affected by the coronavirus pandemic. METHOD: We conducted a national survey of Black Americans (N = 1,497) in February/March 2021. RESULTS: We found that, among the five psychological antecedents, three (confidence, calculation - or extensive information searching, and collective responsibility) significantly predicted attitudes toward COVID-19 vaccination and had indirect effects on vaccination intentions through vaccination attitudes. Two antecedents (confidence and collective responsibility) also directly predicted vaccination intentions. Our analysis suggests that a partially mediated model produced better fit than a fully mediated model. CONCLUSIONS: Developing culturally tailored interventions for Black Americans that build confidence in COVID-19 vaccines, highlight collective responsibility, and attend to Black Americans' information sources is key to boosting Black Americans' COVID-19 vaccine acceptance. Future research is needed to understand how historical and ongoing racism affects the psychological antecedents of COVID-19 vaccine acceptance among Black Americans.

A Scoping Review of Emerging COVID-19 Health Communication Research in Communication and Media Journals.

This article reports a scoping review of emerging research on COVID-19 health communication. We reviewed and analyzed 206 articles published in 40 peer-reviewed communication journals between January 2020 to April 2021. Our review identified key study characteristics and overall themes and trends in this rapidly expanding field of research. Our review of health communication scholarship during the early stages of the COVID-19 pandemic suggests that health communication scholars have risen to the challenges and interrogated important issues in COVID-19 communication at the individual, group, organizational, and societal levels. We identified important gaps that warrant future research attention including experimental research that seeks to test the causal effects of communication, studies that evaluate communication interventions in under-served populations, research on mental health challenges imposed by the pandemic, and investigations on the promise of emerging communication technologies for supporting pandemic mitigation efforts.

Public Perceptions of Food Contamination Risks: A Simulation Experiment on the Psychological Impact of Incident Severity and Intentionality.

How do consumers perceive risks associated with food contamination? How do they respond to foodborne illness outbreaks and food recalls resulting from food contamination? We report findings from an experiment (N = 1,010) in which participants were exposed to a simulated news report on a food contamination incident that had led to a foodborne illness outbreak and voluntary food recalls. Two characteristics of the food contamination incident were experimentally manipulated - severity (i.e., how serious the consequences of the incident were) and intentionality (i.e., whether the incident was caused by an accident or an intentional act to harm). We found that higher severity generally led to higher risk perceptions and risk-reduction intentions. A contamination incident attributed to an intentional act to harm, as opposed to an accident, caused greater intentions to temporarily reduce consumption of the contaminated food and to seek out more information, but only when incident severity was relatively low. Implications of these findings for effectively communicating food contamination risks are discussed.

Moral Foundations Predict COVID-19 Vaccine Hesitancy: Evidence from a National Survey of Black Americans.

In this study we examine the role of moral values in predicting COVID-19 vaccine hesitancy among Black Americans. Guided by moral foundations theory, we assess the associations between six moral foundations (care, fairness, loyalty, authority, purity, liberty) and attitudes and intentions toward COVID-19 vaccination. Results of a national survey of Black Americans (N = 1,497) indicate that the care and loyalty moral foundations consistently predicted less vaccine hesitancy with overall more favorable attitudes and intentions toward COVID-19 vaccination, whereas the purity and liberty moral foundations were consistently associated with greater vaccine hesitancy. Relationships between the foundations and vaccine hesitancy were mediated by perceived vaccine effectiveness and safety. Implications of the findings for COVID-19 vaccine communication are discussed.

Why do people believe health misinformation and who is at risk? A systematic review of individual differences in susceptibility to health misinformation.

RATIONALE: Health misinformation poses a significant threat to public health. Understanding why people believe health misinformation and who is at risk is crucial for developing effective interventions to reduce the harmful impact of misinformation. APPROACH: We conducted a systematic review of published empirical research that examined individual differences in susceptibility to health misinformation, focusing on the psychological, demographic, and behavioral correlates of health misinformation susceptibility. To guide our review on psychological correlates, we developed an integrative psychological model of susceptibility to health misinformation based on one's ability and motivation to reason. RESULTS: We identified 47 publications (61 empirical studies) that met our criteria. Our review suggests that subject knowledge, literacy and numeracy, analytical thinking (vs. intuitive thinking), and trust in science confer strong resistance to health misinformation, whereas conspiracy thinking, religiosity, conservative ideology, and conservative party identification are associated with more susceptibility to health misinformation. Demographically, older age and higher educational attainment predict less susceptibility to health misinformation, whereas racial minority status is associated with greater susceptibility. Behaviorally, relying on health professionals or scientists as information sources predicts less susceptibility to health misinformation, whereas social media use is associated with greater susceptibility. CONCLUSIONS: Susceptibility to health misinformation is driven by multiple psychological processes. Interventions for reducing the spread and impact of health misinformation should be tailored to the psychological mechanism underlying susceptibility to health misinformation. Limited resources should be used to support interventions targeted at individuals at risk.

Impact of Self-Affirmation on Responses to Health Warning Messages: Does Consideration of Future Consequences Matter?

Self-affirmation theory has inspired numerous studies that have tried to understand the effects of self-affirmation on defensive processing of threatening health messages and subsequent behavior. Despite the overall positive effects of self-affirmation, psychological processes through which self-affirmation exerts such impact remain unclear. We examined Consideration of Future Consequences (CFC) as a potential moderator of the effects of self-affirmation on responses to graphic cigarette warning warnings, in an attempt to shed light on the psychological processes. We conducted an experimental study in which 925 African American smokers were instructed to self-affirm (or not) prior to viewing graphic cigarette warning labels. We found that smokers with stronger present time orientation (PTO) experienced higher defensive responses as measured by anger, perceived message manipulation, and message derogation, after viewing graphic cigarette warning labels; whereas smokers with stronger future time orientation (FTO) reported less message derogation. PTO interacted with self-affirmation in predicting defensive processing measures, such that self-affirmation reduced message derogation at lower levels of PTO and increased message derogation and perceived message manipulation at higher levels of PTO. Self-affirmation also had a conditional indirect effect on smoking intentions and intention to quit smoking through measures of defensive processing. We discuss implications of our study.

General and health-related social media use among adults with children in the household: Findings from a national survey in the United States.

OBJECTIVE: Examine predictors of social media use among a nationally representative sample of adults with children in the household. METHODS: Data were collected from the Health Information National Trends (HINTS) Survey from 2017 to 2020 (N = 3559). Multivariate logistic regression models assessed the association between sociodemographic variables and social networking site (SNS) use, SNS use to share health information, participation in online forum or support groups for health issues and watching health-related videos on YouTube. RESULTS: Older adults and men were significantly less likely to use social media (p<.05). Non-Hispanic African American (aOR: 1.83; 95%CI: 1.30-2.57), Hispanic (aOR: 2.16; 95%CI: 1.56-2.99), and Asian (aOR: 2.82; 95%CI: 1.67-4.75) adults were more likely to watch health-related videos on YouTube. CONCLUSIONS: Racial/ethnic minorities with children in the household were more likely to seek health information on YouTube, highlighting opportunities to disseminate culturally relevant, accurate messages on the platform. Effective health communication targeted to specific demographics can help counter misinformation and promote health behavior particularly during public health emergencies. PRACTICE IMPLICATIONS: Providers need to foster trust so that patients are comfortable to ask questions in addition to seeking information online. Providers can direct patients to credible resources to counter misinformation exposure and promote healthy behavior.

Public Health Messaging during the COVID-19 Pandemic and Beyond: Lessons from Communication Science.

The COVID-19 pandemic has made it clear that effective public health messaging is an indispensable component of a robust pandemic response system. In this article, we review decades of research from the interdisciplinary field of communication science and provide evidence-based recommendations for COVID-19 public health messaging. We take a principled approach by systematically examining the communication process, focusing on decisions about what to say in a message (i.e., message content) and how to say it (i.e., message executions), and how these decisions impact message persuasiveness. Following a synthesis of each major line of literature, we discuss how science-based principles of message design can be used in COVID-19 public health messaging. Additionally, we identify emerging challenges for public health messaging during the COVID-19 pandemic and discuss possible remedies. We conclude that communication science offers promising public health messaging strategies for combatting COVID-19 and future pandemics.

Human Papillomavirus Vaccine Acceptability and Campaign Message Preferences Among African American Parents: a Qualitative Study.

Human papillomavirus (HPV) vaccination can prevent numerous cancers, yet uptake remains low for adolescents. Given disproportionate burden of cancers among African Americans, it is important to identify factors that influence HPV vaccination decisions among African American parents, specifically the role and preferences of vaccine campaign messages. The objectives of this study were to (1) identify the predictors of parents' decisions to get their children vaccinated against HPV, (2) assess parents' evaluation of current HPV vaccination campaign messages, and (3) uncover message strategies or themes parents consider to be effective and motivating to vaccinate their children against HPV. Focus groups were conducted with African American mothers and fathers (n = 18) in person. Several themes emerged regarding HPV vaccine acceptability including the desire to be informed, the unfamiliarity of vaccination, and mistrust toward government, pharmaceutical companies, and healthcare providers. Parental review of existing campaign messages highlighted the importance of clarifying risks and benefits of vaccination, including cancer prevention, and the preference for straightforward language. When brainstorming strategies to craft effective messages, parents highlighted need for the inclusion of diverse groups across race, gender, and age. Additionally, parents recommended clear language on side effects, eligibility, and additional resources for further information. Our findings highlight concerns and potential strategies to promote HPV vaccination tailored to African American parents and their children. Targeted interventions to increase vaccination need to consider the importance of building trust and representation in health promotional materials. Considerations for how messages were shared were also discussed such as physical locations, word of mouth, and social media.

African American Parents' Perceived Vaccine Efficacy Moderates the Effect of Message Framing on Psychological Reactance to HPV Vaccine Advocacy.

This experiment assessed how the frame of promotional vaccine messages elicited psychological reactance differently for African American parents according to their level of perceived vaccine efficacy. We found that those with low perceived HPV vaccine efficacy experienced more psychological reactance in response to loss-framed messages compared to gain-framed messages, whereas message framing made little difference for those with high perceived HPV vaccine efficacy. In addition, the interaction between frame and perceived HPV vaccine efficacy indirectly affected parents' intentions to vaccinate their child for HPV via reactance. These results support current theorizing about framing effects under defensive message processing specifically as it applies to psychological reactance.

Self-Affirmation Does Not Change Smokers' Explicit or Implicit Attitudes toward Smoking Following Exposure to Graphic Cigarette Warning Labels.

Self-affirmation has shown promise in promoting pro-health attitudes following exposure to threatening health messages by reducing defensive processing of such messages. We examine the impact of self-affirmation prior to viewing graphic cigarette warning labels on implicit and explicit attitudes toward smoking in a sample of African American smokers (N = 151). Participants held negative explicit and implicit attitudes toward smoking. We found no direct effect of self-affirmation on either implicit or explicit attitudes. Self-affirmation and risk level did not interact to predict either attitude type. We discuss findings in terms of self-affirmation theory, attitude measurement, and the meta-cognitive model of attitude change.

Social media use and human papillomavirus awareness and knowledge among adults with children in the household: examining the role of race, ethnicity, and gender.

BACKGROUND: Though human papillomavirus (HPV) vaccination is a safe and effective method of protecting against associated cancers, uptake rates remain low among adolescents. Few studies have examined how social media use contributes to HPV-related knowledge gaps among parents and caregivers. OBJECTIVE: To investigate the association between social media use and HPV-related awareness and knowledge with a focus on differences by gender and race/ethnicity among a nationally representative sample of adults with children in the household. METHODS: We used data from the Health Information National Trends (HINTS) Survey (2017-2019) (N = 2,720). Multivariate logistic regressions were used to examine the association of social media use on HPV awareness and knowledge outcomes. RESULTS: Compared to non-users, engaging in one, two, three, or four social media behaviors were associated with greater HPV awareness (aOR: 2.09; 95%CI: 1.18-3.70, aOR: 2.49; 95%CI: 1.40-4.42, aOR: 2.64; 95%CI: 1.15-6.05, and aOR: 2.44; 95%CI: 1.11-5.36, respectively). Increased social media use was associated with increased HPV vaccine awareness. Men, African American, Hispanic, and Asian American respondents were less likely to be aware of HPV or HPV vaccine. Social media use was not associated with cancer knowledge. CONCLUSIONS: Increased social media use is associated with an increased awareness of HPV and HPV vaccine for adults with children in the household. Social media-based efforts can be utilized to increase knowledge of the benefits of HPV vaccination as cancer prevention, which may be a precursor to reducing HPV vaccine hesitancy and encouraging uptake to decrease cancer incidence rates among vulnerable populations.

HPV Vaccine Searches on Pinterest: Before and After Pinterest's Actions to Moderate Content.

Objectives. To compare how human papillomavirus (HPV) vaccination was portrayed on Pinterest before and after the platform acted to moderate vaccine-related search results to understand (1) what the information environment looked like previously and (2) whether Pinterest's policy decisions improved this environment in terms of sources and content.Methods. In this quantitative content analysis, we compared 2 samples of 500 HPV vaccine-focused Pinterest posts ("pins") collected before and after Pinterest's actions to provide more reliable vaccine-related information. Pins were based on search results and were analyzed using the Health Belief Model.Results. The majority of preaction search results leaned toward vaccine skepticism, specifically focused on perceived vaccine barriers. Few pins were published by public health-related Pinterest accounts. Postaction search results showed a significant shift to HPV vaccination benefits, and the number of pins by government or medical accounts increased. However, the proportion of pins in search results containing HPV content of any type was significantly lower.Conclusions. Pinterest's efforts to moderate vaccination discussions were largely successful. However, the ban also appeared to limit HPV vaccination search results overall, which may contribute to confusion or an information vacuum.

Influence of Risk Severity and Intentionality on Perceptions of Food Contamination Risks among Pregnant Women: An Experimental Investigation.

Given the potential for severe health consequences of consuming contaminated foods during pregnancy, effective communication of food contamination risks to pregnant women is especially important. This study examines pregnant women's risk perceptions and intentions to adopt risk-reduction behaviors following exposure to a simulated news story about a food contamination incident. The news story was experimentally manipulated to depict the severity of the incident as high or low and the cause of the incident as accidental or intentional. Results showed that both severity and intentionality of the incident elevated pregnant women's perceptions of getting sick as well as their intentions to temporarily reduce consumption of the contaminated food product and to seek more information. Implications of these findings for effectively communicating food contamination risks to pregnant women are discussed.

Soda or VitaSoda: How Product Name Influences Perceptions of Snack Food Healthfulness and the Moderating Role of Nutrition Facts Labels.

Many parts of a food package label can influence consumers' product judgments. In this study we investigate how strategic product naming influences consumers' perceptions of snack food products' healthfulness and nutritional content by focusing on snack food names that include (versus do not include) the noun "vita." We also analyze how the effects of product naming are moderated by viewing the Nutrition Facts labels (NFLs). In an online experiment, participants (N = 3,049) were presented with mock packages of snack foods and given the opportunity to view the NFL. Results showed that products including "vita" in their name were perceived as more healthful than those that did not include "vita" in their name, even though their nutritional content was the same. Additionally, vita snack foods (compared to regular snack foods) were rated as significantly higher in nutrients to promote, such as fiber, vitamin D, calcium, vitamin C, and potassium and lower in nutrients to limit, such as calories, sugar, and saturated fat. Viewing the NFL appeared to mitigate the effects of product naming.