Exploring Political Mistrust in Pandemic Risk Communication: Mixed-Method Study Using Social Media Data Analysis.

BACKGROUND: This research extends prior studies by the Finnish Institute for Health and Welfare on pandemic-related risk perception, concentrating on the role of trust in health authorities and its impact on public health outcomes. OBJECTIVE: The paper aims to investigate variations in trust levels over time and across social media platforms, as well as to further explore 12 subcategories of political mistrust. It seeks to understand the dynamics of political trust, including mistrust accumulation, fluctuations over time, and changes in topic relevance. Additionally, the study aims to compare qualitative research findings with those obtained through computational methods. METHODS: Data were gathered from a large-scale data set consisting of 13,629 Twitter and Facebook posts from 2020 to 2023 related to COVID-19. For analysis, a fine-tuned FinBERT model with an 80% accuracy rate was used for predicting political mistrust. The BERTopic model was also used for superior topic modeling performance. RESULTS: Our preliminary analysis identifies 43 mistrust-related topics categorized into 9 major themes. The most salient topics include COVID-19 mortality, coping strategies, polymerase chain reaction testing, and vaccine efficacy. Discourse related to mistrust in authority is associated with perceptions of disease severity, willingness to adopt health measures, and information-seeking behavior. Our findings highlight that the distinct user engagement mechanisms and platform features of Facebook and Twitter contributed to varying patterns of mistrust and susceptibility to misinformation during the pandemic. CONCLUSIONS: The study highlights the effectiveness of computational methods like natural language processing in managing large-scale engagement and misinformation. It underscores the critical role of trust in health authorities for effective risk communication and public compliance. The findings also emphasize the necessity for transparent communication from authorities, concluding that a holistic approach to public health communication is integral for managing health crises effectively.

Identifying factors influencing COVID-19 vaccine uptake in Finland - a qualitative study using social media data.

Introduction: Vaccine demand creation requires understanding what is driving the uptake of the vaccine. 24 Qualitative research methods are paramount to gaining a localized understanding of behavioral 25 drivers and barriers to vaccine uptake, but they are often underutilized. Methods: This is a qualitative study that 26 used public comments on the Facebook and Twitter posts of the Finnish Institute for Health and 27 Welfare (THL) as data sources to identify behavioral drivers for COVID-19 vaccine uptake in 28 Finland. The participatory data analysis utilized thematic analysis and the Theoretical Domains 29 Framework (TDF). NVIVO was used to assist in the coding process. Results: The greatest number of FB and 30 Twitter comments were linked with six TDF domains: knowledge, environmental context and 31 resources, beliefs in consequences, beliefs in capabilities, social and professional role, and social 32 influences. The domains included 15 themes that were interlinked. The knowledge domain 33 overlapped with all other domains. Discussion: By using public discourse on Facebook and Twitter, and rapid 34 qualitative data analysis methods within a behavioral insight framework, this study adds to the 35 emerging knowledge about behavioral drivers of COVID-19 vaccines that can be used by public 36 health experts to enhance the uptake of vaccines during future pandemics and epidemics.

COVID-19 risk perception framework of the public: an infodemic tool for future pandemics and epidemics.

Understanding the risk perceptions of the public is central for risk communications and infodemic management during emergency and preparedness planning as people's behavior depends on how they perceive the related risks. This qualitative study aimed to identify and describe factors related to COVID-19 risk perceptions of the public in Finland and to make this information readily available to those who communicate with the public during crises. The study is part of a larger project exploring crisis narratives through a mixed-methods approach. The study was based on a dataset of over 10,000 comments on the Facebook and Twitter posts of the Finnish Institute of Health and Welfare (THL) between March-May 2021. The data were analyzed qualitatively using thematic analysis. The study identified concepts linked with the pandemic risk perception that included knowledge, perceptions, personal experiences, trust, attitudes, and cultural values. The findings resulted in a framework of risk perceptions that can be used as taxonomy and a set of key concepts and keywords in social listening to monitor risk perception during future epidemics and pandemics.

Policy windows for drug consumption rooms in Finland.

Background: Use of drug consumption rooms is a novel harm reduction approach to reach marginalised and isolated people who used drugs, under the high risk of overdose deaths and infectious diseases. The aim of this article was to evaluate the policy opportunities and barriers of the Helsinki City initiative for establishing the first drug consumption room (DCR) in Finland from the multiple streams framework. Method: A qualitative interview research method is used to evaluate the perspectives of stakeholders. By including 23 participants, we analysed the political, social and policy level advantages and disadvantages of the current initiative. Findings: Our results show that the cost of DCRs, the COVID-19 burdens on public resources, the requirement of legislative change, public unawareness, potential policy failure of DCRs, and its impacts on electoral votes constitute the main policy barriers. On the other hand, an increase in drug-related deaths, economic benefits of DCR for society, its effects on street safety and public order, being a local initiative, prospectus change in national drug strategy plans and motivation to catch up with EU standards were underlined as policy opportunities. Four issues, leadership, moral perspective, social change and generational differences, act as mediating factors, which are fluctuated according to public opinions and political environment. Conclusion: By applying the multiple streams framework, our results show that experts' DCR problematisation is still beyond the public and political interest, which needs additional effort around problem identification and prioritisation. Besides public unawareness, the COVID-19 situation seems to be postponing policy progress since the primary attention and available funds have already been dedicated to public health. Already having a local initiative and an upcoming drug strategy plan might be good formal leverage, but unexpected events might also trigger discussions.

Harm reduction in Europe: a framework for civil society-led monitoring.

BACKGROUND: Civil society organisations (CSOs) play a vital role in developing and implementing effective measures to reduce the harms of drug use. They are also fundamental actors to monitor and evaluate programmes and policies for improvement. While harm reduction services are subject to monitoring, and international and European indicators exist, a framework for civil society-led monitoring does not exist. This paper analyses the challenges and added values of developing such a framework for the European region. METHODS: Since 2018, a technical working group within Correlation-European Harm Reduction Network (C-EHRN) is developing and revising a monitoring framework, collecting-through National Focal Points-the experience of harm reduction service providers and service users in 34 European countries. The first round of data collection, in 2019, focused on hepatitis C, overdose prevention, new drug trends and civil society involvement in drug policies. RESULTS: Developing CSO-based harm reduction monitoring is a learning by doing process. Assuring reliability and national representativeness of the data was a central challenge. As most CSOs have little or no experience with monitoring and research and work in a local-based context, the monitoring approach and its indicators were adjusted to the local context in the second round, bringing more in-depth information and helping to improve results' reliability. While this implied shifting from the initial focus on comparing responses at a national level, the change to collecting qualitative data reflecting local realities of service policies and delivery provides the foundations for a critical appraisal of these realities against European policy goals. This allowed to map discrepancies between official policies and their implementation, as well as identify gaps in and complement data collection from national-level agencies. CONCLUSIONS: By focusing on local experiences regarding the delivery of global and European policy targets, C-EHRN monitoring uses the unique strengths of its CSOs network and generates information that complements the reporting by other monitoring agencies. Data reflecting the CSOs perspective is essential for optimising local planning of service provision and development of effective and respectful drug policies at national and European level. If data quality issues, as well as the sustainability of reporting, are adequately addressed, civil society monitoring can provide excellent added value for the monitoring of harm reduction in Europe.

Could 30 years of political controversy on needle exchange programmes in Sweden contribute to scaling-up harm reduction services in the world?

Aims: To end the hepatitis and AIDS epidemics in the world by 2030, countries are encouraged to scale-up harm reduction services and target people who inject drugs (PWID). Blood-borne viruses (BBV) among PWID spread via unsterile injection equipment sharing and to combat this, many countries have introduced needle and syringe exchange programmes (NEP), though not without controversy. Sweden's long, complicated harm reduction policy transition has been deviant compared to the Nordic countries. After launch in 1986, no NEP were started in Sweden for 23 years, the reasons for which are analysed in this study. Methods: Policy documents, grey literature and research mainly published in 2000-2017 were collected and analysed using a hierarchical framework, to understand how continuous build-up of evidence, decisions and key events, over time influenced NEP development. Results: Sweden's first NEP opened in a repressive-control drug policy era with a drug-free society goal. Despite high prevalence of BBV among PWID with recurring outbreaks, growing research and key-actor support including a NEP law, no NEP were launched. Political disagreements, fluctuating actor-coalitions, questioning of research, and a municipality veto against NEP, played critical roles. With an individual-centred perspective being brought into the drug policy domain, the manifestation of a dual drug and health policy track, a revised NEP law in 2017 and removal of the veto, Sweden would see fast expansion of new NEP. Conclusions: Lessons from the Swedish case could provide valuable insight for countries about to scale-up harm reduction services including how to circumvent costly time- and resource-intensive obstacles and processes involving ideological and individual moral dimensions.

Estimating the Needs of Substance Problem Use Services: An Exercise in Seven Finnish Municipalities Using Nationally Collected, Municipal-Level Survey and Register Data†.

OBJECTIVE: The needs of substance problem use services (SPUSs) should ideally be assessed locally to support the provision of appropriate, cost-effective services for the population. In this article we present a model for estimating the adult population's potential needs for and actual use of SPUSs. We used Finnish survey and register data as material for a qualitative assessment. The purpose of our article is to contribute to a discussion on the dimensions of assessment of the need for SPUSs at a local level. METHOD: Seven Finnish municipalities were chosen as examples. The need for SPUSs was assessed by freely available register and survey data of the use of services, substance use and problem use, side effects of use, and lack of social support. Babor et al.'s (2008) description of links between the use of services and need for treatment, in terms of substance use and general social conditions, and Ritter's (2014a) set of methods for assessing the need for treatment are used as theoretical background. RESULTS: The number of people using SPUSs varied from one municipality to the next. The local service system policy and the general well-being of the population have a remarkable role in the use of SPUSs. CONCLUSIONS: Estimations of need and demand with indicators can be useful for local treatment system policy but must be interpreted with thorough knowledge of the local treatment and social handling resources and general social situation. Comparisons between different local areas should be made with caution.

Gambling in Finland: problem gambling in the context of a national monopoly in the European Union.

AIM: To describe and analyse the Finnish gambling market, regulatory system and the state of gambling research as well as the treatment system in operation for problem gamblers. METHOD: A review of the literature and official documents relating to gambling in Finland, focusing primarily on the 1990s and 2000s. RESULTS: Only in recent years have gambling problems become a major issue for public debate in Finland. One reason for the increase in activity to address gambling problems is that, after Finland became a member of the European Union in 1995, the Finnish state gambling monopoly and its compatibility with European Union (EU) regulations have been questioned repeatedly. Since 2000, the Finnish government has put significant new resources into the research as well as the prevention and treatment of gambling problems. The resources grew from almost nothing to several million Euros in less than 10 years. This could be seen as an attempt to protect the national gambling monopoly system by showing that the Finnish monopoly system meets EU requirements. CONCLUSIONS: Since joining the European Union in 1995, the Finnish government has been able to maintain its gambling monopoly by providing substantial resources to signal a commitment to minimizing problem gambling.

From political controversy to a technical problem? Fifteen years of opioid substitution treatment in Finland.

BACKGROUND: The aim of the article is to analyze changes in opioid substitution treatments (OST) in Finland. OST spread in Finland in the late 1990s and early 2000s (Phase 1). Since then, OST has become an integrated part of Finnish drug policy and is provided in various substance abuse treatment units as well as in municipal health centers (Phase 2). METHODS: The paper analyses the policy around the implementation of opioid substitution treatment in Finland, focusing on identifying the key factors and the relations between them that have contributed to the implementation of OST in Finland. RESULTS: OST has become accepted in Finland during the past ten years as a crucial element of a harm reduction strategy. Present incentives behind this development are not as clearly related to drug-specific policies as in the late 1990s; rather, they stem from both the restructuring of health care services (e.g. cost-effectiveness) and the strengthening of the medical or technico-administrative approach to the development of OST. CONCLUSION: Since the early 2000s, the development of substitution treatment in Finland has not taken place under explicit drug-political guidance, but largely as a result of many differing intended and unintended effects. One of the unintended effects is the fact that buprenorphine has replaced heroin as the most commonly misused opioid in Finland.

Drug user organizations in the Nordic countries--local, national, and international dimensions.

The article focuses on drug user organizations that represent and advocate for active "hard drug" users in the Nordic countries. It discusses the opportunities and challenges that these organizations face in their search for legitimacy and political influence. The comparative perspective points at similarities and differences in national contexts that both support and challenges the existence of drug user organizations, including drug policy, social welfare policy, trends in drug use, and organizational conditions. The article also discusses the importance of international network and transnational organizations that support drug user organizations.

How the harm reduction movement contrasts itself against punitive prohibition.

On the basis of the harm reduction movement's founding texts from the beginning of the 1990s, this paper reflects the movement's self-understanding in contrasting itself with the system of punitive prohibition. Following this is a discussion of the implications for drug users of harm reduction claims-making. The paper concludes that the principles of the harm reduction movement resonate extremely well with the moral sensibilities of our contemporary societies, and but that the movement's claims for an amoral, rational, just, and emancipating approach to drug use are to be seen rather as a powerful rhetorical intervention in the highly moralised landscape of drug debate than something that would be achieved in practice.