#EndtheSTIgma: An Exploratory Analysis of the 2019 HPV Awareness Day Conversation on Twitter & Instagram.

The current study explores the risk communication conversations on Twitter and Instagram in the context of the 2019 HPV Awareness Day, through the theoretical lenses of the stigma associated with HPV, HPV-related cancer, and the HPV vaccine. Our findings reveal that: 1) self and enacted stigma are present in these social media conversations, via nonprofits and official ambassadors, and via regular people; 2) other categories related to stigma, which can be seen as reactions to stigma and appeals to better individuals and society (i.e. stopping stereotypes) also emerged in these conversations, via official and not official sources, pro and against vaccine discourses; and 3) the same categories emerged from the data via both platforms, but differences exist in terms of narratives and messaging. Practical implications are discussed.

Public thoughts on incentivizing COVID-19 vaccine uptake in the United States: testing hostile media bias with user-generated comments.

Facebook is the most popular social media platform and often used by news organizations to distribute content to broad audiences. Features of this online news environment, especially user-generated comments shown to news consumers, have the potential to induce audience perceptions of hostile media bias. This study furthers investigation into the influence of exposure to Facebook comments and news topics on consumers. Using a sample of U.S. adult Facebook users (N = 1,274), this work utilized a 2 (likeminded comments or disagreeable comments) × 2 (story topic of requiring COVID-19 vaccines to receive a monetary bonus or maintain employment) between-subjects experimental design. While controlling for the influence of partisanship, this work further proves that features of the Facebook environment uniquely influence news audience perceptions of neutral news content. Specifically, findings indicate that news story topic can influence perceptions of bias. Further, topic and comment exposure interacted, demonstrating the intensity of story topic and likeminded comments enhance hostile media perceptions.

COVID-19 Vaccine Hesitancy: Disadvantaged Groups' Experience with Perceived Barriers, Cues to Action, and Attitudes.

PURPOSE: Drawing from the Health Belief Model, we explored how disadvantaged groups in the U.S., including Black, Hispanic, less educated and wealthy individuals, experienced perceived barriers and cues to action in the context of the COVID-19 vaccination. DESIGN: A cross-sectional survey administered in March 2021. SETTING: USA. SUBJECTS: A national sample of U.S. residents (n = 795) recruited from Prolific. MEASURES: Perceived barriers (clinical, access, trust, religion/spiritual), cues to action (authorities, social circles), attitudes toward COVID-19 vaccination. ANALYSIS: Factor analysis and Structural Equation Model (SEM) were performed in STATA 16. RESULTS: Black and less educated individuals experienced higher clinical barriers (CI [.012, .33]; CI [.027, .10]), trust barriers (CI [.49, .92]; CI [.057, .16]), and religious/spiritual barriers (CI [.28, .66]; CI [.026, .11]). Hispanics experienced lower levels of clinical barriers (CI [-.42, .0001]). Clinical, trust, and religious/spiritual barriers were negatively related to attitudes toward vaccination (CI [-.45, -.15]; CI [-.79, -.51]; CI [-.43, -.13]). Black and less educated individuals experienced fewer cues to action by authority (CI [-.47, -.083]; CI [-.093, -.002]) and social ties (CI [-.75, -.33]; CI [-.18, -.080]). Lower-income individuals experienced fewer cues to action by social ties (CI [-.097, -.032]). Cues from social ties were positively associated with vaccination attitudes (CI [.065, .26]). CONCLUSION: Communication should be personalized to address perceived barriers disadvantaged groups differentially experience and use sources who exert influences on these groups.

Exposure Effects or Confirmation Bias? Examining Reciprocal Dynamics of Misinformation, Misperceptions, and Attitudes Toward COVID-19 Vaccines.

This longitudinal study integrates exposure effects and confirmation bias under the theoretical framework of dynamic motivation activation (DMA) to examine the dynamic reciprocity of misinformation, misperceptions, and attitudes in the context of COVID-19 vaccination. Results from a three- national survey showed that misinformation exposure, misperceptions, and attitudes toward COVID-19 vaccines reinforced themselves over time. Further, misperceptions reduced subsequent pro-vaccine attitudes, and pro-vaccine attitudes in turn decreased subsequent misperceptions. Longitudinal mediation analysis also indicated that attitudes reinforced themselves through misperceptions. Surprisingly, we did not find a significant impact of misinformation exposure on subsequent misperceptions or effects of attitudes on subsequent misinformation exposure. These findings highlight the importance of addressing misperceptions regarding COVID-19 vaccines and provide insights for theoretical development in research on exposure effects and confirmation bias.

Social distancing during COVID-19: threat and efficacy among university students in seven nations.

COVID-19 has been spreading fast worldwide, and until effective and safe vaccines have been widely adopted, preventive measures such as social distancing are crucial to keep the pandemic under control. The study's research questions asked which psychosocial factors predict social distancing behavior and whether there are country-level differences in social distancing? Using the Extended Parallel Process Model (EPPM) as a theoretical lens, we examined the predictive effects of threat and efficacy and demographic variables on adherence to the COVID-19 preventive behavior of social distancing using a survey among an international sample of university students. Using path modeling and analysis of covariance, we confirmed the predictive effects of the EPPM on social distancing behavior. Our final model showed that perceived susceptibility to COVID-19 was both directly and indirectly (through response efficacy) associated with social distancing behavior; that perceived severity of COVID-19 yielded a significant indirect effect on social distancing behavior through both self-efficacy and response efficacy; that perceived susceptibility is indirectly and positively associated with social distancing behavior through response efficacy; and that self-efficacy and response efficacy were directly associated with social distancing behavior. Additionally, there were country-level differences in social distancing. Possible explanations for and implications of these findings are discussed.

COVID-19 Vaccine Demand and Financial Incentives.

BACKGROUND: Public health experts estimate that only very high COVID-19 vaccine uptake levels can result in herd immunity. OBJECTIVE: This study's main objective was to evaluate the impact of vaccine price levels, including payments, and the efficacy levels on COVID-19 vaccine demand. METHODS: Data for this study were collected from an online survey of 2000 US individuals aged 18 years and older, which included a set of contingent valuation questions. Parametric and nonparametric procedures were used to estimate the distribution of willingness-to-pay and willingness-to-accept values for the vaccine and to assess its association with vaccine efficacy levels (50, 70, and 95%). RESULTS: Most of the individuals (60%) indicated they were willing to pay a positive amount for the vaccine; 13.7% said they would only accept the vaccine if it were free; 14.1% were willing to take the vaccine only if they were paid; and 12.2% were not willing to accept the vaccine. The vaccine efficacy level was found to affect an individual's demand for the vaccine. Estimated mean willingness-to-pay values were: US$594, US$706, and US$723 for vaccines with efficacy levels of 50, 70, and 95%, respectively. CONCLUSIONS: US individuals highly value the COVID-19 vaccine, and about 88% of the US population would accept the vaccination; however, 14% indicated they would get vaccinated if compensated. Payments of about US$500 or more would be needed to sufficiently incentivize 50% or more of this group vaccinated.

Stay Socially Distant and Wash Your Hands: Using the Health Belief Model to Determine Intent for COVID-19 Preventive Behaviors at the Beginning of the Pandemic.

BACKGROUND: The COVID-19 pandemic has quickly spread around the world, and since currently no treatments that are safe and effective for large groups of people nor a vaccine are available, the best way to prevent the illness is to avoid being exposed to the virus causing it. The purpose of this study was to examine the predictive effects of both demographic and psychosocial factors originating with the Health Belief Model on reported intent to adhere to COVID-19 preventive behaviors (e.g., social distancing, hand washing, and not attending large gatherings). METHOD: A Qualtrics survey of 500 U.S. adults was conducted to explore the relationships of demographics and psychosocial factors with the intent to adhere to COVID-19 preventive measures. RESULTS: Gender was a predictor of taking preventive action, with women more likely to take action. Health Belief Model constructs predicted uptake of most COVID-19 preventive actions, but the constructs often appeared to work independent of the model. Race/ethnicity was an infrequent predictor, but when it did, minorities were less likely to report intent to adhere to COVID-19 preventive behaviors. CONCLUSION/IMPLICATIONS: While not a perfect model for this pandemic, the Health Belief Model and its constructs should continue to be considered for use by public health communicators focusing on preventive measure campaign design in both the COVID-19 pandemic era and beyond.

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.

(S)pin the flu vaccine: Recipes for concern.

Influenza epidemics happen yearly, and the World Health Organization estimates that the virus is connected to between 290,000 and 650,000 annual deaths. The most effective way to prevent seasonal influenza is vaccination. The prevalence of vaccine misinformation on social media is increasing, but the visual platform Pinterest is understudied in this area. The current study is the first to explore the content and nature of influenza information that is shared on Pinterest. Using a quantitative content analysis, Pinterest messages were theoretically analyzed for Health Belief Model variables as well as for message source, engagement, and position on vaccination. Findings showed concerning trends but also promising opportunities for health organizations and professionals.