Winning! Election returns and engagement in social media.

This article analyzes social media engagement when elections are adjudicated to one of the contending parties. We extend existing models of political dialogue to explain differences in social media engagement (i.e. time-to-retweet) when users support the winner or losers of an election. We show that users who support the winning candidate are more engaged and have a lower time-to-retweet. We also show heterogeneity in Twitter engagement conditional on the number of followers, with accounts with more followers being less sensitive to the election result. We measure the effect of electoral adjudication using a regression discontinuity design, with estimates by winning or losing status, and for accounts with many followers (high authority) or with few followers (low authority). Analyses use Twitter data collected in Argentina (2019), Brazil (2018), the United Kingdom (2019), and the United States (2016).

Fake health news in the new regime of truth and (mis)information / Fake news sobre saúde no novo regime de verdade e informações (in)corretas / Fake news sobre salud en el nuevo régimen de verdad y (des)información

The phenomenon of fake news in public health worldwide reflects significant changes in the regime of health information, particularly in the West. It reveals a transition from a scenario in which the medical community arguably dominated the flow of health information ­ grounded in the biomedical model ­ to a more crowded, competitive and chaotic scenario. The digital revolution has upended the old regime by transforming the large-scale production, distribution and consumption of health information. Consequently, misinformation and disinformation have become widespread, as the public is able to obtain information about health issues from an array of sources and platforms, and rogue actors flood the internet with factually incorrect information, hearsay and conspiracy theories.

O fenômeno de fake news na saúde pública mundial reflete mudanças significativas no regime de informações sobre saúde, particularmente no Oeste. Esse fenômeno revela uma transição de um cenário em que a comunidade médica possivelmente dominava o fluxo de informação sobre saúde ­ com base no modelo biomédico ­ para um cenário mais sobrecarregado, competitivo e caótico. A revolução digital inverteu o regime antigo através da transformação da produção, distribuição e consumo de informações sobre saúde em larga escala. Consequentemente, informações incorretas e desinformação se tornaram generalizadas, já que o público é capaz de obter informações sobre assuntos de saúde de todo um conjunto de fontes e plataformas, e atores desonestos inundam a internet com informação factualmente incorreta, boatos e teorias de conspiração.

El fenómeno de fake news en la salud pública mundial refleja importantes cambios en el régimen de información sobre salud, principalmente en Occidente. Revela una transición de una situación de presumible dominio de la comunidad médica del flujo de información sobre salud ­ basada en un modelo biomédico, a otro escenario más saturado, competitivo y caótico. La revolución digital ha invertido el antiguo régimen transformando en gran escala la producción, distribución y consumo de la información sobre salud. Consecuentemente, ha habido una generalización de desinformación y datos falsos debido a la capacidad del público de adquirir conocimientos sobre asuntos de salud de diversas fuentes y plataformas. Y así actores deshonestos inundan Internet con información factualmente incorrecta, rumores y teorías conspiratorias.

Successful polio eradication in Uttar Pradesh, India: the pivotal contribution of the Social Mobilization Network, an NGO/UNICEF collaboration.

In Uttar Pradesh, India, in response to low routine immunization coverage and ongoing poliovirus circulation, a network of U.S.-based CORE Group member and local nongovernmental organizations partnered with UNICEF, creating the Social Mobilization Network (SMNet). The SMNet's goal was to improve access and reduce family and community resistance to vaccination. The partners trained thousands of mobilizers from high-risk communities to visit households, promote government-run child immunization services, track children's immunization history and encourage vaccination of children missing scheduled vaccinations, and mobilize local opinion leaders. Creative behavior change activities and materials promoted vaccination awareness and safety, household hygiene, sanitation, home diarrheal-disease control, and breastfeeding. Program decision-makers at all levels used household-level data that were aggregated at community and district levels, and senior staff provided rapid feedback and regular capacity-building supervision to field staff. Use of routine project data and targeted research findings offered insights into and informed innovative approaches to overcoming community concerns impacting immunization coverage. While the SMNet worked in the highest-risk, poorly served communities, data suggest that the immunization coverage in SMNet communities was often higher than overall coverage in the district. The partners' organizational and resource differences and complementary technical strengths posed both opportunities and challenges; overcoming them enhanced the partnership's success and contributions.

Comunicación y salud en la Argentina / Communication and health in Argentina

Contenido: Desafíos de salud publica en la Argentina. La salud en los medios. Comunicación médica institucional. Campañas e intervenciones. Política de salud y comunicación.

Communication for polio eradication: improving the quality of communication programming through real-time monitoring and evaluation.

Communication is a critical component in assuring that children are fully immunized and that simultaneous immunity is attained and maintained across large geographic areas for disease eradication and control initiatives. If service delivery is of good quality and outreach to the population is active, effective communication--through advocacy, social mobilization, and program communication (including behavior change activities and interpersonal communication)--will assist in raising awareness, creating and sustaining demand, preventing or dispelling misinformation and doubts, encouraging acceptance of and participation in vaccination services, more rapid reporting of disease cases and outbreaks, and mobilizing financial resources to support immunization efforts. There is evidence of 12% to 20% or more increases in the absolute level of immunization coverage and 33% to 100% increases in relative coverage compared to baselines when communication is included as a key component of immunization strengthening. This article utilizes evidence from Afghanistan, India, Pakistan, and Nigeria to examine how the Global Polio Eradication Initiative has utilized monitoring and evaluation data to focus and improve the quality and impact of communication activities.

The complexity of social mobilization in health communication: top-down and bottom-up experiences in polio eradication.

The Polio Eradication Initiative (PEI) has been one of the most ambitious global health efforts in recent times. Social mobilization (SM) has been a strategic component of the PEI. Yet, a close-up analysis of SM dynamics seems to be lacking in the health communication literature. We examine critical aspects of the PEI experience in an attempt to move from dominant informational perspectives to a focus on emerging challenges in polio eradication efforts and new levels of complexity to SM. We examine available literature on communication and public health, available data on SM experiences that support polio eradication in Africa and Asia, and field work conducted by the authors where polio eradication efforts are ongoing. Our analysis suggests that (1) SM should not be casually approached as a top-down informational strategy to advance pre-established health goals; (2) centralized strategies hardly amount to SM; and (3) hybrid options that combine both activist and pragmatic SM are concrete possibilities for global health initiatives. In the context of renewed global democratization and persistent conflicts rooted in ethnicity, religion, and economics, it cannot be assumed that communities will either diligently espouse global goals or necessarily oppose them. Communication and SM strategies should rely on a clear understanding of the motives and agendas of involved actors. Resistance or opposition are important analytical dimensions as they may uncover new opportunities for effective health interventions. Further studies using these perspectives should be a priority for global health programs, including studies of the trust level, or lack thereof, among social actors.

Participatory communication for tuberculosis control in prisons in Bolivia, Ecuador, and Paraguay.

OBJECTIVES: To assess the challenges in reducing tuberculosis (TB) in prisons in Bolivia, Ecuador, and Paraguay and propose ways to address them through communication interventions. METHODS: Challenges to two central goals of TB control--early diagnosis of positive cases and successful application of the directly observed treatment, short course (DOTS) strategy--were examined. Data were gathered (through in-depth, structured interviews) and focus groups were conducted in the prisons that housed the largest number of male inmates in each country. Interviewees and focus group participants included program directors, administrative personnel, correctional health and security staff, and incarcerated people who were or had been under treatment for TB and had participated as 'peers' in health services. RESULTS: The findings showed a range of entrenched obstacles for adequate TB control. Stigmatizing attitudes and low knowledge about TB among inmates and key prison personnel discouraged people living in prisons from seeking diagnosis and treatment. Systemic problems in prison health services, along with squalid living conditions, lack of coordination between national TB programs and prison health systems, and insufficient allocation of resources to health prevented the provision of adequate TB prevention and care. CONCLUSION: In addressing the barriers to effective TB control in prison systems in Bolivia, Ecuador, and Paraguay, a participatory approach to communication is necessary.

Participatory communication for tuberculosis control in prisons in Bolivia, Ecuador, and Paraguay / Comunicación participativa para el control de la tuberculosis en cárceles de Bolivia, Ecuador y Paraguay

Objectives: To assess the challenges in reducing tuberculosis (TB) in prisons in Bolivia, Ecuador, and Paraguay and propose ways to address them through communication interventions. Methods: Challenges to two central goals of TB control-early diagnosis of positive cases and successful application of the directly observed treatment, short course (DOTS) strategy-were examined. Data were gathered (through in-depth, structured interviews) and focus groups were conducted in the prisons that housed the largest number of male inmates in each country. Interviewees and focus group participants included program directors, administrative personnel, correctional health and security staff, and incarcerated people who were or had been under treatment for TB and had participated as "peers" in health services. Results: The findings showed a range of entrenched obstacles for adequate TB control. Stigmatizing attitudes and low knowledge about TB among inmates and key prison personnel discouraged people living in prisons from seeking diagnosis and treatment. Systemic problems in prison health services, along with squalid living conditions, lack of coordination between national TB programs and prison health systems, and insufficient allocation of resources to health prevented the provision of adequate TB prevention and care. Conclusion: In addressing the barriers to effective TB control in prison systems in Bolivia, Ecuador, and Paraguay, a participatory approach to communication is necessary.

Objetivos: Identificar los desafíos para reducir la tuberculosis (TB) en cárceles de Bolivia, Ecuador y Paraguay y recomendar vías para solucionarlos mediante intervenciones informativas. Métodos: Se analizaron las dificultades para alcanzar dos metas centrales del control de la TB: el diagnóstico temprano de los casos positivos y la aplicación exitosa del tratamiento bajo supervisión directa de curso corto. Se obtuvieron datos (mediante entrevistas estructuradas en profundidad) y se convocaron grupos focales en las cárceles con más reclusos hombres en cada país. Entre los entrevistados y el grupo focal había directores de programas, personal administrativo, sanitario y de seguridad de las cárceles, así como reclusos que recibían o habían recibido tratamiento contra la TB y que habían participado como "pares" en los servicios de salud. Resultados: Se detectaron obstáculos arraigados que impedían el control adecuado de la TB. Las actitudes estigmatizadoras y el escaso conocimiento sobre la TB entre los reclusos y el personal clave de las prisiones desestimulaban la búsqueda de diagnóstico y tratamiento en las cárceles. Los problemas sistémicos de los servicios de salud de las prisiones, junto con las insalubres condiciones de vida, la falta de coordinación entre los programas nacionales de TB y los sistemas de salud de las prisiones, y la insuficiente asignación de recursos sanitarios impidieron brindar una prevención adecuada y un cuidado eficaz de la TB. Conclusión: Para eliminar las barreras al control eficaz de la TB en los sistemas carcelarios de Bolivia, Ecuador y Paraguay se requiere de un enfoque participativo de comunicación.

Beyond the medical-informational model: recasting the role of communication in tuberculosis control.

Although communication has recently gained increased recognition in tuberculosis (TB) control programs, current thinking and practice remains boxed within the epistemological boundaries of the "bio-medical" model. The latter posits that information about transmission and care is crucial to promote early diagnosis and treatment. However, when populations confront a series of socio-cultural and structural barriers to access TB care, medical knowledge and awareness alone cannot effectively promote ideal practices. The article suggests that communication programs need to adopt a "social rationality" perspective based on nuanced understanding of community experience of TB. Suggestions are offered about how communication contributes to addressing challenges in TB control.

When training is insufficient: reflections on capacity development in health promotion in Peru.

The international development community has lately recognized the programatic importance of capacity development. Despite growing attention, a consensus is still lacking on appropriate strategies and interventions to strengthen local capacity for development programs. The CHANGE Project designed and implemented a program to contribute to capacity development in health promotion in Peru between 2002 and 2005. This article discusses key lessons learned in the program. Successful capacity development requires the strengthening of institutional networks. Training activities alone are insufficient. Educational opportunities need to be integrated into strategies that aim to institutionalize competencies in specific work contexts and promote the inter-institutional linkages. The experience suggests that capacity development programs need to start by assessing challenges to make competencies effective in job performance. Projects should neither be donor-driven nor depend on individuals. Instead, they should focus on institution building, find creative ways to promote long-term sustainability of capacity development, and require long-term commitment to promote ownership and sustainability. What is needed is an approach that maximizes the impact of programs through collaboration among institutions committed to supporting and absorbing capacity, and to having mechanisms to monitor and change job performance according to the needs of staff, supervisors and other stakeholders.