"A Victim of Our Own Success:" Testing Jenny's First Sleepover's Dark Satire to Improve Attitudes Toward Childhood Vaccination.

The COVID-19 pandemic resulted in substantially lower uptake of childhood vaccinations in the U.S. As vaccination rates struggle to rebound, childhood vaccine hesitancy continues to grow. Addressing vaccine disinformation and increasing catch-up vaccination is an urgent public health priority. The purpose of this study was to evaluate the effectiveness of "Jenny's First Sleepover," a darkly humorous satirical book about childhood vaccinations, to influence attitudes of vaccine hesitant parents. This study implemented a randomized pretest - posttest experimental design using a web-based survey with one intervention and one control. "Jenny's First Sleepover" improved attitudes toward vaccination among vaccine hesitant parents. Negative emotions were an important mediator of attitudes toward vaccinations. Findings identify mechanisms that increase effectiveness of satirical approaches, including the presentation of novel information about serious vaccine-preventable diseases with a dark narrative twist. Health communicators may consider a darkly humorous satirical approach to improve attitudes toward childhood vaccination among vaccine hesitant parents.

Uncertainty and Negative Emotions in Parental Decision-making on Childhood Vaccinations: Extending the Theory of Planned Behavior to the Context of Conflicting Health Information.

Delaying childhood vaccinations has become a public health threat. Numerous studies have shown that the proliferation of conflicting information about the health effects of childhood vaccinations leads parents to believe misinformation about the outcomes of these vaccinations. To build upon the limited understanding of how conflicting information affects decision-making of health protective behaviors, this study extends and applies the theory of planned behavior (TPB) in the context of childhood vaccinations. This study integrates perceived uncertainty as an antecedent of the TPB model, and incudes the negative emotions resulting from the uncertainty as a parallel predictor for the model to examine parents' acceptance of and engagement in childhood vaccinations. Drawing from a survey of with parents in the United States (N = 405), we found that both perceived uncertainty and subjective norms are strong predictors of parents' attitudes and perceived control regarding childhood vaccinations. Additionally, our study also proved that affective factors and the other three cognitive components in TPB are equally important on the formation of parents' intentions of childhood vaccinations. Theoretical and practical implications are discussed in this study.

Identifying and Analyzing Health-Related Themes in Disinformation Shared by Conservative and Liberal Russian Trolls on Twitter.

To combat health disinformation shared online, there is a need to identify and characterize the prevalence of topics shared by trolls managed by individuals to promote discord. The current literature is limited to a few health topics and dominated by vaccination. The goal of this study is to identify and analyze the breadth of health topics discussed by left (liberal) and right (conservative) Russian trolls on Twitter. We introduce an automated framework based on mixed methods including both computational and qualitative techniques. Results suggest that Russian trolls discussed 48 health-related topics, ranging from diet to abortion. Out of the 48 topics, there was a significant difference (p-value ≤ 0.004) between left and right trolls based on 17 topics. Hillary Clinton's health during the 2016 election was the most popular topic for right trolls, who discussed this topic significantly more than left trolls. Mental health was the most popular topic for left trolls, who discussed this topic significantly more than right trolls. This study shows that health disinformation is a global public health threat on social media for a considerable number of health topics. This study can be beneficial for researchers who are interested in political disinformation and health monitoring, communication, and promotion on social media by showing health information shared by Russian trolls.

Preparing for A COVID-19 Vaccine: A Mixed Methods Study of Vaccine Hesitant Parents.

This study investigated vaccine acceptance of putative COVID-19 vaccines among a national sample of vaccine hesitant parents. Vaccine hesitancy and politicization of vaccine development has led to a pronounced distrust of COVID-19 vaccines in the U.S. A total of 1,381 vaccine-hesitant parents participated in this study. Participants indicated a general unwillingness to vaccinate their children (M = 3.55, SD = 2.13) and themselves (M = 3.58, SD = 2.16) when a COVID-19 vaccine becomes available. More educated parents were more likely to plan to vaccinate themselves [F(5, 533) = 9.93, p < .05] and their children [F(5, 533) = 10.278, p < .05]. Understanding vaccine hesitant parents offers crucial insights as a COVID-19 vaccine becomes available for the general public and as we wait for a vaccine to be approved for pediatric use.

From Social Media to Mainstream News: The Information Flow of the Vaccine-Autism Controversy in the US, Canada, and the UK.

Despite increasing warnings about inaccurate information online, little is known about how social media contribute to the widespread diffusion of unverified health information. This study addresses this issue by examining the vaccine-autism controversy. By looking into a large dataset of Twitter, Reddit posts, and online news over 20 months in the US, Canada, and the UK, our time-series analysis shows that Twitter drives news agendas, and Reddit follows news agendas regarding the vaccine-autism debate. Additionally, the results show that both Twitter and Reddit are more likely to discuss the vaccine-autism link compared to online news content.

An Exploratory Survey of Older Women's Post-Fall Decisions.

This research examined factors influencing older women's post-fall decision making. We surveyed 130 independent older women from continuing care retirement communities and non-institutional homes. We categorized women's post-fall decisions as medical, corrective, and social decisions, and examined the associations between post-fall decision categories, decisional conflict, number of post-fall changes, self-rated health, frequency of falls, severity of falls, health literacy, awareness and openness to long-term care institutional options, and demographics. Older women experienced greater decisional conflict when making medical decisions versus social ( p = .012) and corrective ( p = .047) decisions. Significant predictors of post-fall decisional conflict were awareness of institutional care options ( p = .001) and health literacy ( p = .001). Future educational interventions should address knowledge deficits and provide resources to enhance collaborative efforts to lower women's post-fall decisional conflict and increase satisfaction in the decisions they make after a fall.

The Andrea Yates Effect: Priming Mental Illness Stereotypes Through Exemplification of Postpartum Disorders.

In a randomized between-subjects design, participants (N = 80) were assigned to one of four conditions, 2 (pregnant, not pregnant) × 2 (extreme prime, moderate prime). It was hypothesized that primes involving moderate mental illness would be positively associated with increased perceived risk of developing postpartum depression. Hayes and Preacher's bootstrapping procedure was used to test the direct, indirect, and conditional indirect effects related to the hypothesized model. In addition, further analyses evaluated whether implicitly activated goals (to be healthy or to be a good mother) were positively associated with increased perceptions of risk and engagement of downstream avoidance behavioral intentions. Findings show that for pregnant participants, the effect of the prime condition on perceived personal risk of developing postpartum depression was mediated by perceptions about the target character's sanity. However, activated "healthy" and "good mother" goals are not influencing behavioral intentions.

Moms and Media: Exploring the Effects of Online Communication on Infant Feeding Practices.

Using a survey of mothers with young children (N = 455), this study applies Fishbein and Ajzen's reasoned action approach (RAA) to examine the relationship between online communication and infant feeding practices. Contrary to expectations, attitudes, perceived normative pressure, and perceived behavioral control (PBC) did not fully mediate the relationship between time spent online and behavioral intentions. Our findings indicate a significant, direct, negative association between time spent online and breastfeeding intentions In this article, theoretical and practical implications for health communication are discussed.

Does Reactance against Cigarette Warning Labels Matter? Warning Label Responses and Downstream Smoking Cessation amongst Adult Smokers in Australia, Canada, Mexico and the United States.

OBJECTIVE: Some researchers have raised concerns that pictorial health warning labels (HWLs) on cigarette packages may lead to message rejection and reduced effectiveness of HWL messages. This study aimed to determine how state reactance (i.e., negative affect due to perceived manipulation) in response to both pictorial and text-only HWLs is associated with other types of HWL responses and with subsequent cessation attempts. METHODS: Survey data were collected every 4 months between September 2013 and 2014 from online panels of adult smokers in Australia, Canada, Mexico, and the US were analyzed. Participants with at least one wave of follow-up were included in the analysis (n = 4,072 smokers; 7,459 observations). Surveys assessed psychological and behavioral responses to HWLs (i.e., attention to HWLs, cognitive elaboration of risks due to HWLs, avoiding HWLs, and forgoing cigarettes because of HWLs) and cessation attempts. Participants then viewed specific HWLs from their countries and were queried about affective state reactance. Logistic and linear Generalized Estimating Equation (GEE) models regressed each of the psychological and behavioral HWL responses on reactance, while controlling for socio-demographic and smoking-related variables. Logistic GEE models also regressed having attempted to quit by the subsequent survey on reactance, each of the psychological and behavioral HWL responses (analyzed separately), adjustment variables. Data from all countries were initially pooled, with interactions between country and reactance assessed; when interactions were statistically significant, country-stratified models were estimated. RESULTS: Interactions between country and reactance were found in all models that regressed psychological and behavioral HWL responses on study variables. In the US, stronger reactance was associated with more frequent reading of HWLs and thinking about health risks. Smokers from all four countries with stronger reactance reported greater likelihood of avoiding warnings and forgoing cigarettes due to warnings, although the association appeared stronger in the US. Both stronger HWLs responses and reactance were positively associated with subsequent cessation attempts, with no significant interaction between country and reactance. CONCLUSIONS: Reactance towards HWLs does not appear to interfere with quitting, which is consistent with its being an indicator of concern, not a systematic effort to avoid HWL message engagement.

Vicarious Experience: Experimentally Testing the Effects of Empathy for Media Characters with Severe Depression and the Intervening Role of Perceived Similarity.

Informed by the findings in prior research, the current study experimentally tested the effects of empathy responses to different types of media characters on attitudes and support for people with depression. In a between-subjects experiment, participants (N = 80) were assigned to one of three conditions. Participants in the first condition read an article about a high-similarity character with severe depression, those in the second condition read an article about a low-similarity character with severe depression, and those in the control group did not read an article. Participants in all three conditions were then shown a stimulus website for a faux peer-support organization. The results indicated that the level of empathic responses, positive attitudes, and the likelihood of joining the organization and engaging in supportive behaviors increased for those who read about a socially similar person with depression.

Thinking outside the medicine cabinet: a comparative content analysis of direct-to-consumer advertisements for prescription drug treatments.

This study content analyzed online direct-to-consumer advertisements (DTCA) for prescription drug treatments to explore whether ads for prescription treatments for psychiatric conditions, which are commonly untreated, differ from other drug advertisements. Coded variables included the presence of interactive technological components, use of promotional incentives, and the social contexts portrayed in images shown on each site. Statistical analysis revealed ads for psychiatric medications contained fewer interactive website features, financial incentives, and calls to action than other types of prescription drug advertisements. Implications for health communication researchers are discussed.

Biodegradation of low concentrations of 1,2-dibromoethane in groundwater is enhanced by phenol.

The lead scavenger 1,2-dibromoethane (EDB), a former additive to leaded gasoline, is a common groundwater contaminant, yet not much knowledge is available for its targeted bioremediation, especially under in situ conditions. The study site was an aviation gas spill site, which, although all hydrocarbons and most of the EDB were remediated in the mid-1990s, still exhibits low levels of EDB remaining in the groundwater (about 11 µg EDB/l). To evaluate the effect of phenol on biostimulation of low concentration of EDB, microcosms were established from an EDB-contaminated aquifer. After 300 days at environmentally relevant conditions (12 ± 2 °C, static incubation), EDB was not significantly removed from unamended microcosms compared to the abiotic control. However, in treatments amended with phenol, up to 80 % of the initial EDB concentration had been degraded, while added phenol was removed completely. Microbial community composition in unamended and phenol-amended microcosms remained unchanged, and Polaromonas sp. dominated both types of microcosms, but total bacterial abundance and numbers of the gene for phenol hydroxylase were higher in phenol-amended microcosms. Dehalogenase, an indicator suggesting targeted aerobic biodegradation of EDB, was not detected in either treatment. This finding suggests phenol hydroxylase, rather than a dehalogenation reaction, may be responsible for 1,2-dibromoethane oxidation under in situ conditions. In addition, biostimulation of EDB is possible through the addition of low levels of phenol in aerobic groundwater sites.

Molecular approach to evaluate biostimulation of 1,2-dibromoethane in contaminated groundwater.

This study investigated the effect of co-substrate amendments on EDB biodegradation under aerobic conditions. Microcosms were established using contaminated soil and groundwater samples and maintained under in situ conditions to determine EDB degradation rates, and the diversity and abundance of EDB degrading indigenous bacteria. After 100days of incubation, between 25% and 56% of the initial EDB was degraded in the microcosms, with added jet fuel providing highest degradation rates (2.97±0.49yr(-1)). In all microcosms, the quantity of dehalogenase genes did not change significantly, while the number of BTEX monooxygenase and phenol hydroxylase genes increased with jet fuel amendments. These results indicate that EDB was not degraded by prior dehalogenation, but rather by cometabolism with adapted indigenous microorganisms. This is also reflected in the history of the plume, which originated from an aviation gasoline pipeline leak. This study suggests that biostimulation of EDB is possible at aerobic groundwater sites.

Biodegradation of ethylene dibromide (1,2-dibromoethane [EDB]) in microcosms simulating in situ and biostimulated conditions.

Although 1,2-dibromoethane (EDB) is a common groundwater contaminant, there is the lack of knowledge surrounding EDB biodegradation, especially under aerobic conditions. We have performed an extensive microcosm study to investigate the biodegradation of EDB under simulated in situ and biostimulated conditions. The materials for soil microcosms were collected from an EDB-contaminated aquifer at the Massachusetts Military Reservation in Cape Cod, MA. This EDB plume has persisted for nearly 40 years in both aerobic and anaerobic EDB zones of the aquifer. Microcosms were constructed under environmentally relevant conditions (field EDB and DO concentrations; incubated at 12°C). The results showed that natural attenuation occurred under anaerobic conditions but not under aerobic conditions, explaining why aerobic EDB contamination is so persistent. EDB degradation rates were greater under biostimulated conditions for both the aerobic and anaerobic microcosms. Particularly for aerobic biostimulation, methane-amended microcosms degraded EDB, on average, at a first order rate eight times faster than unamended microcosms. The best performing replicate achieved an EDB degradation rate of 7.0 yr(-1) (half-life (t(1/2))=0.10 yr). Residual methane concentrations and the emergence of methanotrophic bacteria, measured by culture independent bacterial analysis, provided strong indications that EDB degradation in aerobic methane-amended microcosms occurred via cometabolic degradation. These results indicate the potential for enhanced natural attenuation of EDB and that methane could be considered co-substrate for EDB bioremediation for the EDB-contaminated groundwater in aerobic zone.

Performance of a pilot-scale packed bed reactor for perchlorate reduction using a sulfur oxidizing bacterial consortium.

A novel sulfur-utilizing perchlorate reducing bacterial consortium successfully treated perchlorate (ClO4⁻) in prior batch and bench-scale packed bed reactor (PBR) studies. This study examined the scale up of this process for treatment of water from a ClO 4⁻ and RDX contaminated aquifer in Cape Cod Massachusetts. A pilot-scale upflow PBR (∼250-L) was constructed with elemental sulfur and crushed oyster shell packing media. The reactor was inoculated with sulfur oxidizing ClO4⁻ reducing cultures enriched from a wastewater seed. Sodium sulfite provided a good method of dissolved oxygen removal in batch cultures, but was found to promote the growth of bacteria that carry out sulfur disproportionation and sulfate reduction, which inhibited ClO4⁻ reduction in the pilot system. After terminating sulfite addition, the PBR successfully removed 96% of the influent ClO4⁻ in the groundwater at an empty bed contact time (EBCT) of 12 h (effluent ClO4⁻ of 4.2 µg L(-1)). Simultaneous ClO4⁻ and NO3⁻ reduction was observed in the lower half of the reactor before reactions shifted to sulfur disproportionation and sulfate reduction. Analyses of water quality profiles were supported by molecular analysis, which showed distinct groupings of ClO4⁻ and NO3⁻ degrading organisms at the inlet of the PBR, while sulfur disproportionation was the primary biological process occurring in the top potion of the reactor.