Addressing Data Absenteeism and Technology Chauvinism in the Use of Gamified Wearable Gloves Among Older Adults: Moderated Usability Study.

BACKGROUND: Digital health technologies have the potential to improve health outcomes for older adults, especially for those recovering from stroke. However, there are challenges to developing these technologies, such as data absenteeism (where older adults' views are often underrepresented in research and development) and technology chauvinism (the belief that sophisticated technology alone is the panacea to addressing health problems), which hinder their effectiveness. OBJECTIVE: In this study, we aimed to address these challenges by developing a wearable glove integrated with culturally relevant exergames to motivate older adults to exercise and, for those recovering from stroke, to adhere to rehabilitation. METHODS: We conducted a moderated usability study with 19 older adults, of which 11 (58%) had a history of stroke. Our participants engaged in a 30-minute gameplay session with the wearable glove integrated with exergames, followed by a quantitative survey and an in-depth interview. We used descriptive analysis to compare responses to the System Usability Scale between those who had a history of stroke and those who did not. In addition, we analyzed the qualitative interviews using a bottom-up thematic analysis to identify key themes related to the motivations and barriers regarding the use of wearable gloves for rehabilitation and exercise. RESULTS: Our study generated several key insights. First, making the exergames exciting and challenging could improve exercise and rehabilitation motivation, but it could also have a boomerang effect, where participants may become demotivated if the games were very challenging. Second, the comfort and ease of use of the wearable gloves were important for older adults, regardless of their stroke history. Third, for older adults with a history of stroke, the functionality and purpose of the wearable glove were important in helping them with specific exercise movements. CONCLUSIONS: Our findings highlight the importance of providing contextual support for the effective use of digital technologies, particularly for older adults recovering from stroke. In addition to technology and usability factors, other contextual factors such as gamification and social support (from occupational therapists or caregivers) should be considered to provide a comprehensive approach to addressing health problems. To overcome data absenteeism and technology chauvinism, it is important to develop digital health technologies that are tailored to the needs of underserved communities. Our study provides valuable insights for the development of digital health technologies that can motivate older adults recovering from stroke to exercise and adhere to rehabilitation.

Examining COVID-19 Tweet Diffusion Using an Integrated Social Amplification of Risk and Issue-Attention Cycle Framework.

Drawing upon the social amplification of risk (SARF) and the issue-attention cycle framework, we examined the amplification of COVID-19 risk-related tweets through (a) topics: key interests of discussion; (b) temperament: emotions of tweets; (c) topography (i.e., location); and (d) temporality (i.e., over time). We computationally analyzed 1,641,273 tweets, and conducted manual content analysis on a subset of 6,000 tweets to identify how topics, temperament, and topography of COVID-19 tweets were associated with risk amplification - retweet and favorite count - using negative binomial regression. We found 11 dominant COVID-19 topics-health impact, economic impact, reports of lockdowns, report of new cases, the need to stay home, coping with COVID-19, news about President Trump, government support, fight with COVID-19 by non-government entities, origins, and preventive measure in our corpus of tweets across the issue-attention cycle. The negative binomial regression results showed that at the pre-problem stage, topics on President Trump, speculation of origins, and initiatives to fight COVID-19 by non-government entities were most likely to be amplified, underscoring the inherent politicization of COVID-19 and erosion of trust in governments from the start of the pandemic. We also found that while tweets with negative emotions were consistently amplified throughout the issue-attention cycle, surprisingly tweets with positive emotions were amplified during the height of the pandemic - this counter-intuitive finding indicated signs of premature and misplaced optimism. Finally, our results showed that the locations of COVID-19 tweet amplification corresponded to the shifting COVID-19 hotspots across different continents across the issue-attention cycle. Theoretical and practical implications of risk amplification on social media are discussed.

Examining Antecedents of Factual Knowledge and Perceived Familiarity of COVID-19 Contact Tracing App: A Modified Cognitive Mediation Model.

This study employs a modified cognitive mediation model to investigate the role of health valuation and fear in shaping media attention, factual knowledge, and perceived familiarity with COVID-19 contact tracing apps. Data were collected from a national survey of 906 Singaporeans, and structural equation modeling was used to analyze the results. Findings indicated that both fear of COVID-19 and health valuation were positively associated with newspapers, television, and social media attention, with health valuation demonstrating a stronger association with each media type. This suggests that health valuation, as an intrinsic motivation, is more critical in information-seeking behavior related to emerging health technologies. However, media attention on all platforms did not correlate with factual knowledge of COVID-19 contact tracing apps, whereas attention to social media was positively associated with perceived familiarity with these apps. This result highlights the potential influence of social media in shaping public perceptions, warranting further investigation into the quality and accuracy of the information disseminated. News elaboration was found to have a positive association with both factual knowledge and perceived familiarity with COVID-19 contact tracing apps. This underscores the need for effective communication strategies to promote accurate understanding of health technologies and emphasizes the role of individual motivations in shaping media consumption and information processing.

Examining Theoretical Frameworks and Antecedents of Health Apps and Wearables Use: A Scoping Review.

The advancement of health apps and wearables has garnered substantial academic attention, particularly in examining why individuals decide to use or not use them. In response to the extensive body of research on this topic, we conducted a scoping review of 61 articles published from 2007 to 2022, aiming to examine the dominant theoretical frameworks and antecedents of health apps and wearables use. The findings demonstrated that the dominant theoretical frameworks within this domain were rooted in the human-computer interaction theories, notably the Technology Acceptance Model and the Unified Theory of Acceptance and Use of Technology. Next, our review identified four levels of antecedents: technological, individual, societal, and policy. At the technological level, emphasis was placed on functionality, reliability, and technological infrastructure. Individual antecedents encompassed socio-demographics, personality traits, cognitive responses to benefits and risks, emotional and affective responses, self-efficacy, and digital literacy. Societal antecedents highlighted the role of social networks and social norms, while policy antecedents elaborated on laws, regulations, and guidelines that encouraged health technology adoption. Our discussion illuminated that the evolving trend of theoretical frameworks in health apps and wearables use research, initially rooted in human-computer interaction, is progressively moving toward more comprehensive perspectives. We further underscored the importance of delving into societal and policy antecedents, which often are overshadowed by the more commonly discussed technological and individual factors. In conclusion, we advocated for a multi-stakeholder collaborative network approach, as this would enable communication researchers to understand the use of health apps and wearables more comprehensively.

Exploring the Incentive Function of Virtual Academic Degrees in a Chinese Online Smoking Cessation Community: Qualitative Content Analysis.

BACKGROUND: Previous studies on online smoking cessation communities (OSCCs) have shown how such networks contribute to members' health outcomes from behavior influence and social support perspectives. However, these studies rarely considered the incentive function of OSCCs. One of the ways OSCCs motivate smoking cessation behaviors is through digital incentives. OBJECTIVE: This study aims to explore the incentive function of a novel digital incentive in a Chinese OSCC-the awarding of academic degrees-to promote smoking cessation. It specifically focuses on "Smoking Cessation Bar," an OSCC in the popular web-based Chinese forum Baidu Tieba. METHODS: We collected discussions about the virtual academic degrees (N= 1193) from 540 members of the "Smoking Cessation Bar." The time frame of the data set was from November 15, 2012, to November 3, 2021. Drawing upon motivational affordances theory, 2 coders qualitatively coded the data. RESULTS: We identified five key topics of discussion, including members' (1) intention to get virtual academic degrees (n=38, 2.47%), (2) action to apply for the degrees (n=312, 20.27%), (3) feedback on the accomplishment of goals (n=203, 13.19%), (4) interpersonal interaction (n=794, 51.59%), and (5) expression of personal feelings (n=192, 12.48%). Most notably, the results identified underlying social and psychological motivations behind using the forum to discuss obtaining academic degrees for smoking cessation. Specifically, members were found to engage in sharing behavior (n=423, 27.49%) over other forms of interaction such as providing recommendations or encouragement. Moreover, expressions of personal feelings about achieving degrees were generally positive. It was possible that members hid their negative feelings (such as doubt, carelessness, and dislike) in the discussion. CONCLUSIONS: The virtual academic degrees in the OSCC created opportunities for self-presentation for participants. They also improved their self-efficacy to persist in smoking cessation by providing progressive challenges. They served as social bonds connecting different community members, triggering interpersonal interactions, and inducing positive feelings. They also helped realize members' desire to influence or to be influenced by others. Similar nonfinancial rewards could be adopted in various smoking cessation projects to enhance participation and sustainability.

From pandemic to Plandemic: Examining the amplification and attenuation of COVID-19 misinformation on social media.

This study examines the proliferation of COVID-19 misinformation through Plandemic-a pseudo-documentary of COVID-19 conspiracy theories-on social media and examines how factors such as (a) themes of misinformation, (b) types of misinformation, (c) sources of misinformation, (d) emotions of misinformation, and (e) fact-checking labels amplify or attenuate online misinformation during the early days of the pandemic. Using CrowdTangle, a Facebook API, we collected a total of 5732 publicly available Facebook pages posts containing Plandemic-related keywords from January 1 to December 19, 2020. A random sample of 600 posts was subsequently coded, and the data were analyzed using negative binomial regression to examine factors associated with amplification and attenuation. Overall, the extended an extended Social Amplification of Risk Framework (SARF) provided a theoretical lens to understand why certain misinformation was amplified, while others were attenuated. As for posts with misinformation, results showed that themes related to private firms, treatment and prevention of virus transmission, diagnosis and health impacts, virus origins, and social impact were more likely to be amplified. While the different types of misinformation (manipulated, fabricated, or satire) and emotions were not associated with amplification, the type of fact-check labels did influence the virality of misinformation. Specifically, posts that were flagged as false by Facebook were more likely to be amplified, while the virality of posts flagged as containing partially false information was attenuated. Theoretical and practical implications were discussed.

Health-Seeking Behavior and Its Associated Technology Use: Interview Study Among Community-Dwelling Older Adults.

BACKGROUND: Understanding older people's health-seeking behavior (HSB) is crucial for uncovering their health needs and priorities and developing appropriate policies to address them and avert their disease progression. Technologies play an active role in our daily lives and have been incorporated into health activities to support the older population and facilitate their HSB. However, previous studies of HSB have mainly focused on behaviors during illness, and there are limited studies on how technologies have been used in older people's health-seeking activities. OBJECTIVE: This study aimed to investigate HSB and the associated technology use among the older population, ultimately proposing implications for practice to address their unmet health needs. METHODS: This paper presents partial data from a large qualitative study, which has been approved by the institutional review board and used a phenomenological approach. Semistructured interviews were conducted between April 2022 and July 2022, either via Zoom (Zoom Video Communications Inc) or face-to-face sessions. Inclusion criteria were being aged ≥50 years, long-term residence in Singapore, and being able to speak English or Mandarin. The interviews were manually transcribed verbatim, and thematic analysis was performed, with the individual as the unit of analysis to understand the patterns of behaviors. RESULTS: In total, 15 interviews were conducted to reach thematic saturation. We identified 5 main consequences of HSB, which were aligned with the original HSB model. Regarding technology use in health seeking, 4 themes were extracted: the most widely used digital technologies are the mobile health apps and wearable devices with the associated wellness programs launched by the government and local companies, and they have the potential to enhance health communication, promote health maintenance, and increase access to health services; information communication technologies and social media, though not primarily designed for health purposes, play a substantial role in easing the process of seeking health information and managing symptoms. Although the outbreak of the COVID-19 pandemic has resulted in some alterations to older adults' well-being, it has catalyzed the adoption of telehealth as a complement to access health care services, and older adults have different considerations when selecting technologies to facilitate their health seeking and fulfill their health needs. Moreover, 4 archetypes were proposed based on our findings and the insights gained from our participants' observations in their social networks. These findings led to several implications for practice regarding health communication and promotion, health education, technology design and improvement, telemonitoring service implementation, and solutions to address the needs of each proposed archetype. CONCLUSIONS: Unlike the commonly held belief that older adults resist technologies and lack technological proficiency, our findings showed that technologies could play a promising role in facilitating older adults' health seeking. Our findings have implications for the design and implementation of health services and policies.

Toward an Extended Infodemiology Framework: Leveraging Social Media Data and Web Search Queries as Digital Pulse on Cancer Communication.

This study aims to extend the infodemiology framework by postulating that effective use of digital data sources for cancer communication should consider four components: (a) content: key topics that people are concerned with, (b) congruence: how interest in cancer topics differ between public posts (i.e., tweets) and private web searches, (c) context: the influence of the information environment, and (d) information conduits. We compared tweets (n = 36, 968) and Google web searches on breast, lung, and prostate cancer between the National Cancer Prevention Month and a non-cancer awareness month in 2018. There are three key findings. First, reliance on public tweets alone may result in lost opportunities to identify potential cancer misinformation detected from private web searches. Second, lung cancer tweets were most sensitive to external information environment - tweets became substantially pessimistic after the end of cancer awareness month. Finally, the cancer communication landscape was largely democratized, with no prominent conduits dominating conversations on Twitter.

Social media may hinder learning about science; social media's role in learning about COVID-19.

Despite widespread concerns that misinformation is rampant on social media, little systematic and empirical research has been conducted on whether and how news consumption via social media affects people's accurate knowledge about COVID-19. Against this background, this study examines the causal effects of social media use on COVID-19 knowledge (i.e., both in the form of factual knowledge and misinformation detection) as well as the underlying mechanisms through which such effects occur. Based on original panel survey data across six weeks (W1 N = 1,363, W2 N = 752) in the U.S., we found that consuming news from social media fostered the perception that one need not actively seek news anymore because it would reach them anyway through their social connections (i.e., "news-finds-me" perception). This, in turn, can make one both uninformed and misinformed about COVID-19 issues. Furthermore, this mediated relationship is stronger among those who experience higher levels of information overload while on social media.

Perceived Information Distortion about COVID-19 Vaccination and Addictive Social Media Use among Social Media Users in Hong Kong: The Moderating Roles of Functional Literacy and Critical Literacy.

During the COVID-19 pandemic, distorted information about the COVID-19 vaccination is widely disseminated through social media. The present study examined the association between perceived information distortion about COVID-19 vaccination on social media, individuals' functional and critical literacy, and addictive social media use (SMU), as well as the moderating roles of functional and critical literacy in the association between perceived information distortion and addictive SMU among social media users in Hong Kong. A web-based, cross-sectional survey was conducted among 411 Chinese citizens from June to August 2021. Findings showed that after adjusting for significant background variables, including age, gender, marital status, education, occupation, and income, functional literacy was negatively associated with addictive SMU. In addition, significant moderation effects of functional literacy and critical literacy were also observed, such that a positive association between perceived information distortion on social media and addictive SMU was significant among participants with lower functional literacy or higher critical literacy. Findings highlight the importance of improving functional literacy in addictive SMU prevention for social media users. Special attention should also be paid to the potential influence of critical literacy on addictive SMUs.

Drug, demon, or donut? Theorizing the relationship between social media use, digital well-being and digital disconnection.

Social media overuse is a central concern in discussions over digital well-being. Digital disconnection is often presented as a solution to this problem, but mixed evidence on its effectiveness suggests we lack understanding of why, how and when disconnection works. Drawing from three recurrent social media metaphors - the drug, demon and donut metaphor - this article aims to advance understanding of social media disconnection by developing a classification of disconnective mechanisms in accordance with three conceptual approaches to social media overuse. This classification provides theory-driven support for differing social media disconnection mechanisms. We discuss its implications for practice and future research.

Examining Twitter Discourse on Electronic Cigarette and Tobacco Consumption During National Cancer Prevention Month in 2018: Topic Modeling and Geospatial Analysis.

BACKGROUND: Examining public perception of tobacco products is critical for effective tobacco policy making and public education outreach. While the link between traditional tobacco products and lung cancer is well established, it is not known how the public perceives the association between electronic cigarettes (e-cigarettes) and lung cancer. In addition, it is unclear how members of the public interact with official messages during cancer campaigns on tobacco consumption and lung cancer. OBJECTIVE: In this study, we aimed to analyze e-cigarette and smoking tweets in the context of lung cancer during National Cancer Prevention Month in 2018 and examine how e-cigarette and traditional tobacco product discussions relate to implementation of tobacco control policies across different states in the United States. METHODS: We mined tweets that contained the term "lung cancer" on Twitter from February to March 2018. The data set contained 13,946 publicly available tweets that occurred during National Cancer Prevention Month (February 2018), and 10,153 tweets that occurred during March 2018. E-cigarette-related and smoking-related tweets were retrieved, using topic modeling and geospatial analysis. RESULTS: Debates on harmfulness (454/915, 49.7%), personal experiences (316/915, 34.5%), and e-cigarette risks (145/915, 15.8%) were the major themes of e-cigarette tweets related to lung cancer. Policy discussions (2251/3870, 58.1%), smoking risks (843/3870, 21.8%), and personal experiences (776/3870, 20.1%) were the major themes of smoking tweets related to lung cancer. Geospatial analysis showed that discussion on e-cigarette risks was positively correlated with the number of state-level smoke-free policies enacted for e-cigarettes. In particular, the number of indoor and on campus smoke-free policies was related to the number of tweets on e-cigarette risks (smoke-free indoor, r49=0.33, P=.02; smoke-free campus, r49=0.32, P=.02). The total number of e-cigarette policies was also positively related to the number of tweets on e-cigarette risks (r49=0.32, P=.02). In contrast, the number of smoking policies was not significantly associated with any of the smoking themes in the lung cancer discourse (P>.13). CONCLUSIONS: Though people recognized the importance of traditional tobacco control policies in reducing lung cancer incidences, their views on e-cigarette risks were divided, and discussions on the importance of e-cigarette policy control were missing from public discourse. Findings suggest the need for health organizations to continuously engage the public in discussions on the potential health risks of e-cigarettes and raise awareness of the insidious lobbying efforts from the tobacco industry.

Examining Organizational, Cultural, and Individual-Level Factors Related to Workplace Safety and Health: A Systematic Review and Metric Analysis.

One major gap in existing health communication research is that few studies have synthesized findings from the literature to map out what are the key factors related to workplace (a) safety awareness, (b) safety risks, (c) health awareness, and (d) health risks. This study bridges the gap by systematically reviewing what these organizational, cultural, and individual-level factors are, and examine the impact of workplace safety and health publications using traditional and alternative metrics in academic and non-academic settings. Through an iterative process of coding, the results revealed six categories of organizational (management commitment, management support, organizational safety communication, safety management systems, physical work environment, and organizational environment), two cultural (interpersonal support and organizational culture), and four individual-level (perception, motivation, attitude, and behavior) factors. In terms of impact, articles that were most impactful in academia (e.g., high citation count) may not necessarily receive the same amount of online attention from the public. Theoretical and practical implications for health communication were discussed.

Uncovering temporal differences in COVID-19 tweets.

In the fight against the COVID-19 pandemic, understanding how the public responds to various initiatives is an important step in assessing current and future policy implementations. In this paper, we analyzed Twitter tweets using topic modeling to uncover the issues surrounding people's discussion of the disease. Our focus was on temporal differences in topics, prior and after the declaration of COVID-19 as a pandemic. Nine topics were identified in our analysis, each of which showed distinct levels of discussion over time. Our results suggest that as the pandemic progresses, the concerns of the public vary as new developments come to light.

We Need the Lens of Equity in COVID-19 Communication.

The ongoing COVID-19 pandemic has brought forward the centrality of public communication as a force for information, and in highlighting the differential impact on diverse segments of the society. Information and communication technologies-led developments including social media have previously been discussed as instruments of democratization of knowledge. However, the evidence so far shows that the promise remains unfulfilled as upper socioeconomic groups acquire information at a faster rate than others. The communication inequalities have only reinforced the existing societal fault lines of race, class and place. As the first pandemic of the social media age, COVID-19 has also given rise to an "infodemic", providing fertile ground for the spread of information, misinformation and disinformation. With limited gatekeeping, an immense amount of unprocessed scientific information is being put forward to publics not trained in science. In this commentary, we offer some propositions on how disinformation on COVID-19 has become mainstreamed through social media's spiral of amplification and what role public communication has in an emergency from a lens of equity. We raise the question of whether the tremendous flow of scientific information during the COVID-19 pandemic has a differential impact on different socioeconomic groups. We propose that more systematic research is urgently needed to understand how mis/disinformation originate, spread and what their consequences are. In our view, research in health communication inequalities is foundational to mitigating the current off-line and online ravages of the pandemic.

Big Data in Context: Addressing the Twin Perils of Data Absenteeism and Chauvinism in the Context of Health Disparities Research.

Recent advances in the collection and processing of health data from multiple sources at scale-known as big data-have become appealing across public health domains. However, present discussions often do not thoroughly consider the implications of big data or health informatics in the context of continuing health disparities. The 2 key objectives of this paper were as follows: first, it introduced 2 main problems of health big data in the context of health disparities-data absenteeism (lack of representation from underprivileged groups) and data chauvinism (faith in the size of data without considerations for quality and contexts). Second, this paper suggested that health organizations should strive to go beyond the current fad and seek to understand and coordinate efforts across the surrounding societal-, organizational-, individual-, and data-level contexts in a realistic manner to leverage big data to address health disparities.

Understanding Factors Associated with Singaporean Adolescents' Intention to Adopt Privacy Protection Behavior Using an Extended Theory of Planned Behavior.

Using an extended theory of planned behavior (TPB), this study explores how the original TPB variables (attitude, subjective norms, and perceived behavioral control), personality traits, privacy concern, past privacy protection behaviors (PPBs), as well as parental mediation strategies relate to adolescents' intention to engage in privacy protection measures. We administered a cross-sectional survey to a nationally representative sample of adolescents (N = 4,920) in Singapore. The sample comprised 50.5 percent females and 49.5 percent males with age ranging from 13 to 21 years (M = 14.73). Results from the hierarchical regression analysis showed that the proposed extended TPB model received partial support. Subjective norms, among the TPB and other factors, have the strongest relationship with adolescents' intention to engage in PPBs on social network sites. Adolescents' privacy concern and their past PPBs are more important in influencing their future PPB compared with personality traits such as neuroticism and extraversion. Adolescents whose parents have engaged in regulated parental mediation are more likely to protect their privacy on SNSs compared with adolescents whose parents have adopted active mediation style.

The Augmented Cognitive Mediation Model: Examining Antecedents of Factual and Structural Breast Cancer Knowledge Among Singaporean Women.

As knowledge acquisition is an important component of health communication research, this study examines factors associated with Singaporean women's breast cancer knowledge using an augmented cognitive mediation model. We conducted a nationally representative study that surveyed 802 women between the ages of 30 and 70 using random-digit dialing. The results supported the augmented cognitive mediation model, which proposes the inclusion of risk perception as a motivator of health information seeking and structural knowledge as an additional knowledge dimension. There was adequate support for the hypothesized paths in the model. Risk perception was positively associated with attention to newspaper, television, Internet, and interpersonal communication. Attention to the three media channels was associated with interpersonal communication, but only newspaper and television attention were associated with elaboration. Interpersonal communication was positively associated with structural knowledge, whereas elaboration was associated with both factual and structural knowledge. Differential indirect effects between media attention and knowledge dimensions via interpersonal communication and elaboration were found. Theoretical and practical implications are discussed.

For Fit's Sake: A Norms-Based Approach to Healthy Behaviors Through Influence of Presumed Media Influence.

Based on the influence of presumed media influence (IPMI) model as the theoretical framework, this study examines how injunctive norms and personal norms mediate the influence of healthy lifestyle media messages on public intentions to engage in two types of healthy lifestyle behaviors-physical activity and healthy diet. Nationally representative data collected from 1,055 adults in Singapore demonstrate partial support for the key hypotheses that make up the extended IPMI model, highlighting the importance of a norms-based approach in health communication. Our results indicate that perceived media influence on others indirectly shaped public intentions to engage in healthy lifestyle behaviors through personal norms and attitude, providing partial theoretical support for the extended IPMI model. Practical implications for health communicators in designing health campaigns media messages to motivate the public to engage in healthy lifestyle are discussed.