Tweeting a Pandemic: Communicating #COVID19 Across the Globe.

The COVID-19 pandemic brought about an urgent need for public health departments to clearly communicate their prevention, testing, and treatment recommendations. Previous research supports that Twitter is an important platform that public health departments use to communicate crisis information to stakeholders. This study aimed to shed light on how international health departments shared relevant information about COVID-19 on Twitter in 2020. We conducted a quantitative content analysis of N = 1,200 tweets from twelve countries, across six continents. COVID-19 prevention behaviors were consistently referenced far more than testing or treatment recommendations across countries. Disease severity and susceptibility were referenced more than recommendation benefits, barriers, and efficacy. Results provide support for how public health departments can better communicate recommendations related to COVID-19 behaviors. Based on these results, implications for public health organizations and public relations practitioners worldwide are discussed, and hands-on action guidelines are provided.

#Arabhealth on Instagram: Examining Public Health Messages to Arabian Gulf State Audiences.

Instagram is a social media platform used for communicating health information to audiences in the member states of the Gulf Cooperation Council (GCC), but little is known about the specific use of the platform for this purpose. This study, focused on 1,000 Instagram posts by the GCC Ministries of Health, analyzed how public health information is discussed differently across the GCC on Instagram, as well as the extent to which Health Belief Model (HBM) variables - a frequently used health behavior theory focused on understanding individual adoption of certain health behaviors - are present in these posts. Results showed that a majority of messages did not include HBM constructs other that perceived benefits and calls to action, limiting their potential for effective public health communication. Results also showed a minority of posts deal with mental health. Recommendations for future best practices are discussed.

Tweeting about #Diseases and #Publichealth: Communicating Global Health Issues across Nations.

Twitter is playing an increasing role in health communications, but little is known about the Twitter use of national health departments in general and across different nations in particular. This quantitative content analysis of 1,200 tweets from 12 national health departments showed that the topics covered in these tweets are often lacking in broad coverage - cardiovascular disease is barely mentioned, while infectious diseases are often highlighted - and the tweets do not try to initiate engagement through creating a two-way dialogue with followers. However, the tweets appear to use Health Belief Model constructs, such as initiating cues to action, mentioning self-efficacy and highlighting perceived benefits of health preventative, treatment or screening options, and this is associated with increased Twitter engagement. The paper ends with recommendations for both future studies and new challenges for the use of Twitter by national health departments.

Using the Health Belief Model to Analyze Instagram Posts about Zika for Public Health Communications.

We analyzed Instagram posts about Zika by using the Health Belief Model. We found a high presence of threat messages, yet little engagement with these posts. Public health professionals should focus on posting messages to increase self-efficacy and benefits of protective behavior, especially when a vaccine becomes available.

Assessing the Association Between E-Cigarette Use and Exposure to Social Media in College Students: A Cross-Sectional Study.

BACKGROUND: Social media platforms provide an indirect medium for encouraging e-cigarette use between individuals and also serve as a direct marketing tool from e-cigarette brands to potential users. E-cigarette users share information via social media that often contains product details or health-related claims. OBJECTIVE: Determine whether e-cigarette use is associated with exposure to e-cigarettes on social media in college students. METHODS: Data from a sample of 258 college students was obtained via a clicker-response questionnaire (90% response rate). Demographic, lifetime and current e-cigarette/cigarette use, and e-cigarette exposure via social media (peer posts or advertisements) were examined. Logistic regression was used to assess the relationship between lifetime and current e-cigarette use and viewing peer posts or advertisements on social media while adjusting for cigarette use and self-posting about e-cigarettes. RESULTS: Overall, 46% of participants reported lifetime e-cigarette use, 16% current e-cigarette use, and 7% were current dual users of e-cigarettes and cigarettes. There were positive and significant associations between lifetime e-cigarette use and viewing peer posts (aOR = 3.11; 95% CI = 1.25-7.76) as well as advertisements (aOR = 3.01; 95% CI = 1.19-7.65) on e-cigarettes via social media after adjusting for cigarette use. Current e-cigarette use was only significantly associated with viewing peer posts via social media (aOR = 7.58; 95% CI = 1.66-34.6) after adjusting for cigarette use. Conclusions/Importance: Almost half of college students view peer posts and advertisements on e-cigarettes via social media. This exposure is associated with individual e-cigarette use. Continued efforts to examine online e-cigarette content are needed to help future interventions decrease e-cigarette use.

Tweeting the #flushot: Beliefs, Barriers, and Threats During Different Periods of the 2018 to 2019 Flu Season.

Influenza epidemics happen every year, with more than 8 million severe cases in 2017. The most effective way to prevent seasonal influenza is vaccination. In recent years, misinformation regarding vaccines abounds on social media, but the flu vaccine is relatively understudied in this area, and the current study is the first 1 to explore the content and nature of influenza information that is shared on Twitter, comparing tweets published in the early flu season with those posted in peak flu season. Using a quantitative content analysis, 1000 tweets from both parts of the flu season were analyzed for use of Health Belief Model (HBM) variables, engagement, and flu vaccine specific variables. Findings show several promising opportunities for health organizations and professionals: HBM constructs were present more frequently than in previous, related studies, and fewer vaccine-hesitant tweets appear to be present. However, the presence of high barriers to flu vaccine uptake increased significantly from early to peak season, including an increase in the mention of conspiracy theories. Flu vaccine related tweets appear to vary in misinformation level and density throughout the flu season. While this should be confirmed by further studies over multiple flu seasons, this a finding that should be considered by public health organizations when developing flu vaccine campaigns on social media.

A path model of psychosocial constructs predicting future Zika vaccine uptake intent.

OBJECTIVE: The recent Zika virus outbreak, while no longer an international public health emergency, is still a serious threat, particularly to pregnant women and babies born to pregnant women infected with the virus. This study examined the predictive effects of psychosocial constructs on self-reported intent to get a future Zika vaccine among women of reproductive age. METHODS: Data were collected using an online survey with a representative sample of 339 women ages 18-49 from the continental United States. The survey addressed variables originating with the Extended Parallel Processing Model (EPPM) as related to future Zika vaccine uptake intent. RESULTS: Three quarters of all respondents reported intention to get a future Zika vaccine. Path modeling revealed a direct effect of perceived susceptibility, self-efficacy, and response efficacy on future Zika vaccine uptake intent, as well as an indirect effect of perceived susceptibility through both self-efficacy and response efficacy. In addition, the final model showed an indirect effect of perceived severity on Zika vaccine uptake intent through self-efficacy and response efficacy and accounted for 54.6% of the variance in vaccination intent. CONCLUSIONS: These findings have implications for future Zika vaccine promotion campaigns. This study confirms the importance of perceived susceptibility, self-efficacy, and response efficacy for use in Zika vaccine uptake campaigns; in addition, when using perceived severity, both self-efficacy and response efficacy should be considered in message design.

Framing and visual type: Effect on future Zika vaccine uptake intent.

INTRODUCTION: The Zika virus is associated with the birth defect microcephaly, and while a vaccine was not available in early- 2017, several were under development. This study's purpose was to identify effective communication strategies to promote uptake of a new vaccine, particularly among women of reproductive age. DESIGN AND METHODS: In order to study the effects of Zika message framing (gain vs. loss) and visual type (photo vs. infographic) on future Zika vaccine uptake intent, a 2×2 between-subjects experiment was performed via an online survey in 2017 among 339 U.S. women of reproductive age (18-49 years). Participants were exposed to one of four messages, all resembling Instagram posts: gain-framed vs. loss-framed infographic, and gain-framed vs. loss-framed photo. These messages were followed by questions about Zika vaccine uptake intent as well as intermediate psychosocial variables that could lead to intent. RESULTS: There was no interaction between framing and visual type (P=0.116), and there was no effect for framing (P=0.185) or visual type (P=0.724) on future Zika vaccine uptake intent, which is likely indicative of insufficient dosage of the intervention. However, when focusing on intermediate psychosocial constructs that are known to influence behavior and intent, gain-framed messages were more effective in increasing subjective norms (P=0.005) as related to a future Zika vaccine, as well as perceived benefits (P=0.016) and self-efficacy (P=0.032). CONCLUSIONS: Gain-framed messages seem to be more effective than loss-framed messages to increase several constructs that could, in turn, affect future Zika vaccine uptake intent. This is a novel finding since, traditionally, loss-framed messages are considered more beneficial in promoting vaccine-related health behaviors.

On pins and needles: how vaccines are portrayed on Pinterest.

Vaccination is an effective public health tool for reducing morbidity and mortality caused by infectious diseases. However, increasing numbers of parents question the safety of vaccines or refuse to vaccinate their children outright. The Internet is playing a significant role in the growing voice of the anti-vaccination movement as a growing number of people use the Internet to obtain health information, including information about vaccines. Given the role the Internet plays in providing vaccination-related communication, coupled with limited research in this area, this study focused on the social media platform Pinterest, analyzing 800 vaccine-related pins through a quantitative content analysis. The majority of the pins were anti-vaccine, and most were original posts as opposed to repins. Concerns about vaccine safety and side effects were oft-repeated themes, as was the concept of conspiracy theory. Pro-vaccine pins elicited consistently more engagement than anti-vaccine pins. Health educators and public health organizations should be aware of these dynamics, since a successful health communication campaign should start with an understanding of what and how publics communicate about the topic at hand.