The use of social media for reproductive health advocacy among physicians: a content analysis of tweets by physicians engaged in reproductive health care.

BACKGROUND: Physician voices on social media are important for health policy advocacy. However, the extent to which physicians use best practices around health communications strategy is unknown. METHODS: We implemented a content analysis of 1373 tweets from 12 physicians who specialize in reproductive health care and participated in a reproductive health-related advocacy training program, to describe their reproductive health advocacy tweets in terms of levels of engagement, tone, framing and target audience. RESULTS: The most common framing centered on identifying abortion and contraception as essential health care services. Approximately one-third used proactive (37%), reactive (33%), and neutral (30%) strategies. Less than one-quarter (19%) of the tweets explicitly self-identified as a physician. CONCLUSIONS: Participants used a range of message frames, tones, and audience engagement tactics, suggesting a deliberate health communications strategy. Advocacy training discusses the importance of these domains when using social media for advocacy.

Supporting US healthcare providers for successful vaccine communication.

BACKGROUND: While many healthcare providers (HCPs) have navigated patients' vaccine concerns and questions prior to the rollout of the COVID-19 vaccines, sentiments surrounding the COVID-19 vaccines have presented new and distinct challenges. OBJECTIVE: To understand the provider experience of counseling patients about COVID-19 vaccinations, aspects of the pandemic environment that impacted vaccine trust, and communication strategies providers found supportive of patient vaccine education. METHODS: 7 focus groups of healthcare providers were conducted and recorded during December 2021 and January 2022, at the height of the Omicron wave in the United States. Recordings were transcribed, and iterative coding and analysis was applied. RESULTS: 44 focus group participants representing 24 US states with the majority (80%) fully vaccinated at the time of data collection. Most participants were doctors (34%) or physician's assistants and nurse practitioners (34%). The negative impact of COVID-19 misinformation on patient-provider communication at both intrapersonal and interpersonal levels as well as barriers and facilitators to patient vaccine uptake are reported. People or sources that play a role in health communication ("messengers") and persuasive messages that impact behavior or attitudes towards vaccination ("messages") are described. Providers expressed frustration in the need to continuously address vaccine misinformation in clinical appointments among patients who remained unvaccinated. Many providers found value in resources that provided up-to-date and evidence-based information as COVID-19 guidelines continued to change. Additionally, providers indicated that patient-facing materials designed to support vaccination education were not frequently available, but they were the most valuable to providers in a changing information environment. CONCLUSIONS: While vaccine decision-making is complex and hinges on diverse factors such as health care access (i.e., convenience, expense) and individual knowledge, providers can play a major role in navigating these factors with their patients. But to strengthen provider vaccine communication and promote vaccine uptake, a comprehensive communication infrastructure must be sustained to support the patient-provider dyad. The findings provide recommendations to maintain an environment that facilitates effective provider-patient communication at the community, organizational and policy levels. There is a need for a unified multisectoral response to reinforce the recommendations in patient settings.

"What gets people in the door": An integrative model of student veteran mental health service use and opportunities for communication.

Objective: To explore barriers and facilitators to mental health care among the student service member and veteran (SSM/V) population, develop an integrative model of mental health service use, and identify health communication opportunities. Participants: Participants were 21 current and former SSM/Vs recruited online and via snowball sampling. Methods: We conducted an emergent thematic analysis of in-depth interviews that took place in February 2021. Results: We identified eight major themes. Two were contextual (military culture, SSM/V identities), three were navigational (career repercussions, recognizing need, service availability/quality), and three were paths forward (high-quality accessible services, veteran peers/spaces, relevant outreach). Conclusions: We recommend higher education institutions promote SSM/V spaces, position mental health care as utilitarian, improve everyday mental health literacy, highlight service accessibility and quality, and deliver communications that reflect the diversity of SSM/V identities beyond the "warrior" archetype.

Posts, Likes, Shares, and DMs: A Qualitative Exploration of How Social Media Is Related to Sexual Agency in Young People.

It is well documented that social interactions have a crucial impact on all aspects of personal development for adolescents, however few studies have documented how social interactions affect a young person's sense of sexual agency. The aim of the current qualitative study was to examine young people's perceptions of their own sexual agency in relation to their social media attitudes and behaviors. Participants (n = 31) were recruited from a nonprofit organization and asked to complete a one-hour in-depth interview and a demographic survey. Using an inductive method, involving constant comparison, we identified four overarching themes: (a) Participants utilize different social media platforms for distinct purposes and are cognizant of each audience; (b) Based on past experiences, participants have negotiated and created their own rules of engagement for online behavior; (c) Participants have different expectations about how others should act online versus how they act in relation to flirty or sexual messages; (d) Participants were concerned about the authenticity of online identities and are aware of vulnerability in online interactions. Our results highlight the need for sexual health researchers to observe social network etiquette closely through the lens of autonomy and agency.

What do urban college students really think about health insurance? A qualitative study.

Objective: To determine barriers and opportunities to health insurance enrollment among an undergraduate students at a large urban university. Participants: Participants were 31 college students enrolled in 4-year and community colleges in the City University of New York (CUNY), and six health services and insurance enrollment specialists who facilitate and assist in the health insurance enrollment process for CUNY students. Methods: Focus groups were conducted with students and in-depth interviews with key informants in May 2017. Results: The research revealed important insights into how students perceive and value insurance and yielded recommendations for the university to improve enrollment of its students. Conclusions: Many colleges can increase student enrollment in health insurance by informing and educating students about the process. Improving enrollment processes can increase insurance rates and improve student population health.

How to be SSB-free: Assessing the attitudes and readiness for a sugar sweetened beverage-free healthcare center in the Bronx, NY.

In recent years, communities and institutions have sought new interventions intended to reduce sugar sweetened beverage (SSB) consumption among children. Among these interventions are "SSB-free zones," where such beverages are not permitted to be consumed on the premises. Insufficient knowledge still exists, however, about the readiness for such restrictive SSB policies within health care institutions. Understanding attitudes toward SSB consumption among adults is necessary to guide an institution-wide policy, where staff and patients serve as role models for parents and their children. We conducted focus groups with health center patients and staff to determine perceptions surrounding health and SSB consumption and to better understand the support and readiness (or lack thereof) for an SSB-free zone intervention prior to its implementation. We found that contextual practices present challenges to breaking personal consumption habits, even if beverages are banned from the worksite. Nevertheless, participants expressed support for SSB-free zones, and recommended more education about the harmful effects of soda and energy drink consumption to help improve acceptability for the policy. We conclude that policies restricting onsite SSB consumption may be more effective when combined with educational information and expressions of understanding that this specific behavior change can be difficult.

Countermarketing Alcohol and Unhealthy Food: An Effective Strategy for Preventing Noncommunicable Diseases? Lessons from Tobacco.

Countermarketing campaigns use health communications to reduce the demand for unhealthy products by exposing motives and undermining marketing practices of producers. These campaigns can contribute to the prevention of noncommunicable diseases by denormalizing the marketing of tobacco, alcohol, and unhealthy food. By portraying these activities as outside the boundaries of civilized corporate behavior, countermarketing can reduce the demand for unhealthy products and lead to changes in industry marketing practices. Countermarketing blends consumer protection, media advocacy, and health education with the demand for corporate accountability. Countermarketing campaigns have been demonstrated to be an effective component of comprehensive tobacco control. This review describes common elements of tobacco countermarketing such as describing adverse health consequences, appealing to negative emotions, highlighting industry manipulation of consumers, and engaging users in the design or implementation of campaigns. It then assesses the potential for using these elements to reduce consumption of alcohol and unhealthy foods.