The language of vaccination campaigns during COVID-19.

Understanding what makes communication effective when designing public health messages is of key importance. This applies in particular to vaccination campaigns, which aim to encourage vaccine uptake and respond to vaccine hesitancy and dispel any myth or misinformation. This paper explores the ways in which the governments of Great Britain (England, Scotland and Wales) promoted COVID-19 vaccination as a first-line strategy and studies health message effectiveness by examining the language of official vaccination campaigns, vaccine uptake across the different nations and the health message preferences of unvaccinated and vaccine sceptic individuals. The study considers communications beginning at the first lockdown until the point when daily COVID-19 updates ended for each nation. A corpus linguistic analysis of official government COVID-19 updates is combined with a qualitative examination of the expression of evaluation in governmental discourses, feedback from a Public Involvement Panel and insights from a nationally representative survey of adults in Great Britain to explore message production and reception. Fully vaccinated, unvaccinated and sceptic respondents showed similar health messaging preferences and perceptions of health communication efficacy, but unvaccinated and sceptic participants reported lower levels of compliance for all health messages considered. These results suggest that issues in health communication are not limited to vaccination hesitancy, and that in the future, successful vaccination campaigns need to address the determining factors of public attitudes and beliefs besides communication strategies.

Critical reflections on three popular computational linguistic approaches to examine Twitter discourses.

Although computational linguistic methods-such as topic modelling, sentiment analysis and emotion detection-can provide social media researchers with insights into online public discourses, it is not inherent as to how these methods should be used, with a lack of transparent instructions on how to apply them in a critical way. There is a growing body of work focusing on the strengths and shortcomings of these methods. Through applying best practices for using these methods within the literature, we focus on setting expectations, presenting trajectories, examining with context and critically reflecting on the diachronic Twitter discourse of two case studies: the longitudinal discourse of the NHS Covid-19 digital contact-tracing app and the snapshot discourse of the Ofqual A Level grade calculation algorithm, both related to the UK. We identified difficulties in interpretation and potential application in all three of the approaches. Other shortcomings, such the detection of negation and sarcasm, were also found. We discuss the need for further transparency of these methods for diachronic social media researchers, including the potential for combining these approaches with qualitative ones-such as corpus linguistics and critical discourse analysis-in a more formal framework.

Understanding Trust and Changes in Use After a Year With the NHS COVID-19 Contact Tracing App in the United Kingdom: Longitudinal Mixed Methods Study.

BACKGROUND: Digital contact tracing (DCT) apps have been implemented as a response to the COVID-19 pandemic. Research has focused on understanding acceptance and adoption of these apps, but more work is needed to understand the factors that may contribute to their sustained use. This is key to public health because DCT apps require a high uptake rate to decrease the transmission of the virus within the general population. OBJECTIVE: This study aimed to understand changes in the use of the National Health Service Test & Trace (T&T) COVID-19 DCT app and explore how public trust in the app evolved over a 1-year period. METHODS: We conducted a longitudinal mixed methods study consisting of a digital survey in December 2020 followed by another digital survey and interview in November 2021, in which responses from 9 participants were explored in detail. Thematic analysis was used to analyze the interview transcripts. This paper focuses on the thematic analysis to unpack the reasoning behind participants' answers. RESULTS: In this paper, 5 themes generated through thematic analysis are discussed: flaws in the T&T app, usefulness and functionality affecting trust in the app, low trust in the UK government, varying degrees of trust in other stakeholders, and public consciousness and compliance dropping over time. Mistrust evolved from participants experiencing sociotechnical flaws in the app and led to concerns about the app's usefulness. Similarly, mistrust in the government was linked to perceived poor pandemic handling and the creation and procurement of the app. However, more variability in trust in other stakeholders was highlighted depending on perceived competence and intentions. For example, Big Tech companies (ie, Apple and Google), large hospitality venues, and private contractors were seen as more capable, but participants mistrust their intentions, and small hospitality venues, local councils, and the National Health Service (ie, public health system) were seen as well-intentioned but there is mistrust in their ability to handle pandemic matters. Participants reported complying, or not, with T&T and pandemic guidance to different degrees but, overall, observed a drop in compliance over time. CONCLUSIONS: These findings contribute to the wider implications of changes in DCT app use over time for public health. Findings suggest that trust in the wider T&T app ecosystem could be linked to changes in the use of the app; however, further empirical and theoretical work needs to be done to generalize the results because of the small, homogeneous sample. Initial novelty effects occurred with the app, which lessened over time as public concern and media representation of the pandemic decreased and normalization occurred. Trust in the sociotechnical capabilities of the app, stakeholders involved, and salience maintenance of the T&T app in conjunction with other measures are needed for sustained use.

The reception of public health messages during the COVID-19 pandemic

Understanding the reception of public health messages in public-facing communications is of key importance to health agencies in managing crises, pandemics, and other health threats. Established public health communications strategies including self-efficacy messaging, fear appeals, and moralising messaging were all used during the Coronavirus pandemic. We explore the reception of public health messages to understand the efficacy of these established messaging strategies in the COVID-19 context. Taking a community-focussed approach, we combine a corpus linguistic analysis with methods of wider engagement, namely, a public survey and interactions with a Public Involvement Panel to analyse this type of real-world public health discourse. Our findings indicate that effective health messaging content provides manageable instructions, which inspire public confidence that following the guidance is worthwhile. Messaging that appeals to the audience's morals or fears in order to provide a rationale for compliance can be polarising and divisive, producing a strongly negative emotional response from the public and potentially undermining social cohesion. Provenance of the messaging alongside text-external political factors also have an influence on messaging uptake. In addition, our findings highlight key differences in messaging uptake by audience age, which demonstrates the importance of tailored communications and the need to seek public feedback to test the efficacy of messaging with the relevant demographics. Our study illustrates the value of corpus linguistics to public health agencies and health communications professionals, and we share our recommendations for improving the public health messaging both in the context of the ongoing pandemic and for future novel and re-emerging infectious disease outbreaks.

The relationship between trust and attitudes towards the COVID-19 digital contact-tracing app in the UK.

During the COVID-19 pandemic, digital contact-tracing has been employed in many countries to monitor and manage the spread of the disease. However, to be effective such a system must be adopted by a substantial proportion of the population; therefore, public trust plays a key role. This paper examines the NHS COVID-19 smartphone app, the digital contact-tracing solution in the UK. A series of interviews were carried out prior to the app's release (n = 12) and a large scale survey examining attitudes towards the app (n = 1,001) was carried out after release. Extending previous work reporting high level attitudes towards the app, this paper shows that prevailing negative attitudes prior to release persisted, and affected the subsequent use of the app. They also show significant relationships between trust, app features, and the wider social and societal context. There is lower trust amongst non-users of the app and trust correlates to many other aspects of the app, a lack of trust could hinder adoption and effectiveness of digital contact-tracing. The design of technology requiring wide uptake, e.g., for public health, should embed considerations of the complexities of trust and the context in which the technology will be used.

Public Adoption of and Trust in the NHS COVID-19 Contact Tracing App in the United Kingdom: Quantitative Online Survey Study.

BACKGROUND: Digital contact tracing is employed to monitor and manage the spread of COVID-19. However, to be effective the system must be adopted by a substantial proportion of the population. Studies of mostly hypothetical contact tracing apps show generally high acceptance, but little is known about the drivers and barriers to adoption of deployed systems. OBJECTIVE: The aim of this study was to investigate adoption of and attitudes toward the NHS (National Health Service) COVID-19 smartphone app, the digital contact tracing solution in the United Kingdom. METHODS: An online survey based on the extended Technology Acceptance Model with the added factor of trust was carried out with a representative sample of the UK population. Statistical analysis showed adoption rates, attitudes toward and trust in the app, and compliance with self-isolation advice and highlighted differences for vulnerable populations (ie, older adults aged 65 years and over and members of Black, Asian, and minority ethnic [BAME] communities). RESULTS: A total of 1001 participants took part in the study. Around half of the participants who had heard of the NHS COVID-19 mobile phone app (490/963, 50.9%; 95% CI 47.8%-54.0%) had downloaded and kept the app, but more than one-third (345/963, 35.8%; 95% CI 32.8%-38.8%) either did not intend to download it or had deleted it. Significantly more BAME respondents than White respondents had deleted the app (16/115, 13.9%; 95% CI 11.8%-16.0%, vs 65/876, 7.4%; 95% CI 5.8%-9.0%), and significantly more older adults 65 years and over than those under 65 years did not intend to download it (44/127, 34.6%; 95% CI 31.7%-37.5%, vs 220/874, 25.2%; 95% CI 22.5%-27.9%). Broadly, one of the reasons for uptake was to help the NHS and other people, especially among older adults, although significantly fewer BAME participants agreed that they did so to help the NHS. Reported compliance with received notifications to self-isolate was high but was significantly lower than reported intended compliance without received notifications. Only one-fifth (136/699, 19.5%; 95% CI 17.0%-22.0%) of participants understood that the decision to send self-isolation notifications was automated by the app. There were a range of significantly more negative views among BAME participants, including lower trust in the NHS, while older adults were often significantly more positive. Respondents without the app reported significantly lower trust and more negative views toward the app and were less likely to report that they understood how the app works. CONCLUSIONS: While compliance on the part of the approximately 50% of participants who had the app was fairly high, there were issues surrounding trust and understanding that hindered adoption and, therefore, the effectiveness of digital contact tracing, particularly among BAME communities. This study highlights that more needs to be done to improve adoption among groups who are more vulnerable to the effects of the virus in order to enhance uptake and acceptance of contact tracing apps.