Scaling and sustaining COVID-19 vaccination through meaningful community engagement and care coordination for underserved communities: hybrid type 3 effectiveness-implementation sequential multiple assignment randomized trial.

BACKGROUND: COVID-19 inequities are abundant in low-income communities of color. Addressing COVID-19 vaccine hesitancy to promote equitable and sustained vaccination for underserved communities requires a multi-level, scalable, and sustainable approach. It is also essential that efforts acknowledge the broader healthcare needs of these communities including engagement in preventive services. METHODS: This is a hybrid type 3 effectiveness-implementation study that will include a multi-level, longitudinal, mixed-methods data collection approach designed to assess the sustained impact of a co-created multicomponent strategy relying on bidirectional learning, shared decision-making, and expertise by all team members. The study capitalizes on a combination of implementation strategies including mHealth outreach with culturally appropriate messaging, care coordination to increase engagement in high priority preventive services, and the co-design of these strategies using community advisory boards led by Community Weavers. Community Weavers are individuals with lived experience as members of an underserved community serving as cultural brokers between communities, public health systems, and researchers to co-create community-driven, culturally sensitive public health solutions. The study will use an adaptive implementation approach operationalized in a sequential multiple assignment randomized trial design of 300 participants from three sites in a Federally Qualified Health Center in Southern California. This design will allow examining the impact of various implementation strategy components and deliver more intensive support to those who benefit from it most. The primary effectiveness outcomes are COVID-19 vaccine completion, engagement in preventive services, and vaccine confidence. The primary implementation outcomes are reach, adoption, implementation, and maintenance of the multicomponent strategy over a 12-month follow-up period. Mixed-effects logistic regression models will be used to examine program impacts and will be triangulated with qualitative data from participants and implementers. DISCUSSION: This study capitalizes on community engagement, implementation science, health equity and communication, infectious disease, and public health perspectives to co-create a multicomponent strategy to promote the uptake of COVID-19 vaccination and preventive services for underserved communities in San Diego. The study design emphasizes broad engagement of our community and clinic partners leading to culturally sensitive and acceptable strategies to produce lasting and sustainable increases in vaccine equity and preventive services engagement. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05841810 May 3, 2023.

How do we differentiate not demonise - Is there a role for healthier processed foods in an age of food insecurity? Proceedings of a roundtable event.

The 'ultra-processed food' (UPF) concept, with classification of foods by 'level of processing' rather than nutrient profiles, and its relationship with health outcomes, is currently a topic of debate among academics and increasingly referred to in the media. The British Nutrition Foundation convened a virtual roundtable on 6th July 2022 to gather views on the use of the term (and current definitions of) UPF for public health messaging, seeking to establish areas of consensus and disagreement and identify topics for further research. A small group of invited expert stakeholders attended, including representatives from academia, policy, behavioural science, communications, health, food science, retail and consumer interests. Participants' discussions clustered into cogent themes which included: problems with the use of definitions for UPF, the lack of causal evidence and defined mechanisms linking processing per se with poor health outcomes, and advice that may result in consumer confusion. There was agreement that many foods classified as UPF are high in fat, sugars and/or salt and public health messages should continue to focus on reducing these in the diet since it is unclear whether reported associations between high intakes of UPF and poor health reflect poorer dietary patterns (defined by nutrient intakes), and nutrient-health relationships are well established. Examples of misalignment were also highlighted (i.e. some foods are classified as UPF yet recommended in food-based dietary guidelines [featuring in healthy dietary patterns]). This raises challenges for consumer communication around UPF. Concern was also expressed about potential unintended consequences, particularly for vulnerable groups, where advice to avoid UPF could create stigma and guilt due to lack of time or facilities to prepare and cook meals from scratch. It could also impact on nutrient intakes, as some foods classified as UPF represent more affordable sources of important nutrients (e.g. packaged wholemeal bread). Discordance between the concept of UPF and current strategies to improve public health, such as reformulation, was also discussed. The group concluded that the use of the concept of UPF in UK policy (e.g. dietary guidelines) would be unhelpful at present. Overall, participants felt that it was more important to focus on providing practical advice around selection of healthier processed foods and making healthier foods more accessible rather than promoting the avoidance of UPF. The latter may act to demonise all foods classified as UPF by current definitions, including some affordable nutrient-dense foods.

One Dose Is Not Enough: The Beneficial Effect of Corrective COVID-19 Information Is Diminished If Followed by Misinformation.

The World Health Organization (WHO) released a series of mythbuster infographics to combat misinformation during the COVID-19 infodemic. While the corrective effects of such debunking interventions have typically been examined in the immediate aftermath of intervention delivery; the durability of these corrective effects and their resilience against subsequent misinformation remains poorly understood. To this end, we asked younger and older adults to rate the truthfulness and credibility of 10 statements containing misinformation about common COVID-19 myths, as well as their willingness to share the statements through social media. They did this three times, before and after experimental interventions within a single study session. In keeping with established findings, exposure to the WHO's myth-busting infographics-(a) improved participants' ratings of the misinformation statements as untruthful and uncredible and (b) reduced their reported willingness to share the statements. However, within-subject data revealed these beneficial effects were diminished if corrective information was presented shortly by misinformation, but the effects remained when further corrective information was presented. Throughout the study, younger adults rated the misinformation statements as more truthful and credible and were more willing to share them. Our data reveal that the benefit of COVID-19 debunking interventions may be short-lived if followed shortly by misinformation. Still, the effect can be maintained in the presence of further corrective information. These outcomes provide insights into the effectiveness and durability of corrective information and can influence strategies for tackling health-related misinformation, especially in younger adults.

A pre- and post-intervention study testing the effect of exposure to languageless animated images communicating COVID-19 preventive behaviours on behavioural intentions and beliefs of Guatemalan adults.

Background: Effective health communication to encourage participation in COVID-19 preventive behaviours is crucial in helping mitigate viral spread. Intentions and beliefs are known determinants of adherence to these behaviours, therefore, health communication interventions based on these constructs may be effective. Visual languageless messages can be particularly useful in multilingual countries, where text-based communications can limit message exposure. This pre- and post-intervention study sought to identify the effect of exposure to languageless animated messages, presented in the Graphic Interchange Format (GIF), communicating COVID-19 preventive behaviours (physical distancing, handwashing, and mask-wearing) on behavioural intentions and beliefs. Methods: Between February and March 2021, a nationally representative sample of 308 Guatemalan adults completed this online survey experiment. Self-reported performance of preventive behaviours, understanding of COVID-19 transmission risk, as well as intentions, self-efficacy, and outcome expectancy beliefs about preventive behaviours were assessed at baseline. Participants were then exposed to a random combination of three of four possible GIFs in random presentation order. Following exposure to each GIF, intentions, self-efficacy, and outcome expectancy beliefs were reassessed. Results: In terms of main effects, GIF exposure was significantly associated with improved intentions, self-efficacy, and outcome expectancy beliefs in relation to physical distancing; intentions and outcome expectancy beliefs in relation to handwashing; and intentions and self-efficacy in relation to mask-wearing. These associations were not dependent on the combination of the three of four possible GIFs presented. Pairwise comparisons revealed that observed improvements in scores were most pronounced from baseline to the first GIF exposure and reduced thereafter. Conclusions: Exposure to languageless GIFs communicating COVID-19 preventive behaviours is associated with improvements in key social-cognitive determinants of those behaviours. Dosage of GIF exposure and durability of effects are issues that warrant further attention so we can better understand the conditions and point at which benefits are maximised. Moreover, the effect on behavioural adherence is yet to be determined. GIFs provide a valuable means to widely disseminate health messages via social media during public health crises, such as COVID-19. When these messages are languageless, the potential reach of dissemination can be maximised.

Narrative elaboration makes misinformation and corrective information regarding COVID-19 more believable.

OBJECTIVE: People gather information about health topics from online channels oftentimes awash with misinformation. Investigating this problem during the COVID-19 pandemic is important, as the misinformation effect occurs when misleading details are embedded in narratives and questions. This pilot study investigated whether narrative elaboration increases believability in misinformation statements about COVID-19, and willingness to share these statements online. RESULTS: Results from our online survey (n = 80) demonstrated that narrative elaboration increased believability in both misinformation and accurate statements, with a more pronounced effect on younger adults. Future research may investigate cognitive vulnerabilities imposed by elaborate narratives embedded in online health misinformation with increased attention on developing misinformation resilience among younger adults.

Dynamics of social corrections to peers sharing COVID-19 misinformation on WhatsApp in Brazil.

OBJECTIVE: Online COVID-19 misinformation is a serious concern in Brazil, home to the second-largest WhatsApp user base and the second-highest number of COVID-19 deaths. We examined the extent to which WhatsApp users might be willing to correct their peers who might share COVID-19 misinformation. MATERIALS AND METHODS: We conducted a cross-sectional online survey using Qualtrics among 726 Brazilian adults to identify the types of social correction behaviors (SCBs) and health and technological factors that shape the performance of these behaviors. RESULTS: Brazil's WhatsApp users expressed medium to high levels of willingness to engage in SCBs. We discovered 3 modes of SCBs: correction to the group, correction to the sender only, and passive or no correction. WhatsApp users with lower levels of educational attainment and from younger age groups were less inclined to provide corrections. Lastly, the perceived severity of COVID-19 and the ability to critically evaluate a message were positively associated with providing corrections to either the group or the sender. DISCUSSION: The demographic analyses point to the need to strengthen information literacy among population groups that are younger with lower levels of educational attainment. These efforts could facilitate individual-level contributions to the global fight against misinformation by the World Health Organization in collaboration with member states, social media companies, and civil society. CONCLUSION: Our study suggests that Brazil's WhatsApp users might be willing to actively respond with feedback when exposed to COVID-19 misinformation by their peers on small-world networks like WhatsApp groups.

Themes, communities and influencers of online probiotics chatter: A retrospective analysis from 2009-2017.

We build on recent examinations questioning the quality of online information about probiotic products by studying the themes of content, detecting virtual communities and identifying key influencers in social media using data science techniques. We conducted topic modelling (n = 36,715 tweets) and longitudinal social network analysis (n = 17,834 tweets) of probiotic chatter on Twitter from 2009-17. We used Latent Dirichlet Allocation (LDA) to build the topic models and network analysis tool Gephi for building yearly graphs. We identified the top 10 topics of probiotics-related communication on Twitter and a constant rise in communication activity. However the number of communities grew consistently to peak in 2014 before dipping and levelling off by 2017. While several probiotics industry actors appeared and disappeared during this period, the influence of one specific actor rose from a hub initially to an authority in the latter years. With multi-brand advertising and probiotics promotions mostly occupying the Twitter chatter, scientists, journalists, or policymakers exerted minimal influence in these communities. Consistent with previous research, we find that probiotics-related content on social media veers towards promotions and benefits. Probiotic industry actors maintain consistent presence on Twitter while transitioning from hubs to authorities over time; scientific entities assume an authoritative role without much engagement. The involvement of scientific, journalistic or regulatory stakeholders will help create a balanced informational environment surrounding probiotic products.

Influences of News and Social Media on Food Insecurity and Hoarding Behavior During the COVID-19 Pandemic.

OBJECTIVES: The aim of this study was to examine how sociodemographic variables and frequency of media consumption affect hoarding behavior and food insecurity concerns during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: A quantitative, nonexperimental, correlational online survey was administered using a convenience sample of 203 participants from the United Kingdom with no medical issues that affected buying behavior during the pandemic to examine perceptions related to food insecurity, and self-reported food hoarding behavior. RESULTS: Younger adults and lower income groups reported higher food insecurity perceptions and hoarding behaviors. Consuming COVID-19 information from websites was significantly associated with food insecurity perceptions, while information from social media was significantly associated with more food hoarding behaviors. CONCLUSIONS: Younger adults and lower income groups are vulnerable populations from the perspective of food insecurity and hoarding behavior in times of health disasters like pandemics. While social media can play a positively catalytic role during crises, excessive online information and misinformation can contribute negatively to public panic and feelings of insecurity. Implications for disaster preparedness and future research are discussed. The findings suggest that age is the main predictor of food insecurity and hoarding behavior, with younger adults more likely to be affected. They also suggest that people are turning to National Health Service (NHS) websites, which were deemed more trustworthy than social media, to avoid "news fatigue" and avoiding speculation. Suggestions for future research were made, specifically to examine people's social support during the pandemic to understand its potential link to stockpiling behavior or food insecurity concerns.

Associations between conflicting nutrition information, nutrition confusion and backlash among consumers in the UK.

OBJECTIVE: To examine the effects of exposure to conflicting nutritional information (CNI) through different forms of media on nutrition-related confusion and backlash among consumers in the UK. DESIGN: Cross-sectional survey administered via Qualtrics among 18-75-year-old participants in the UK. The sample was stratified by age and gender with quotas defined according to the 2011 UK census distribution. SETTING: Qualtrics' Online panel of respondents in the UK. PARTICIPANTS: 676 participants comprising nearly an equal number of females (n 341) and males (n 335) and a majority (58·6 %) from households whose income was <£30 000. RESULTS: Our findings showed that nearly 40 % of respondents were exposed to some or a lot of CNI. We found that while exposure to CNI from TV and online news increased nutrition confusion, CNI from health professionals increased backlash. Exposure to CNI from social media and health websites was associated with reduced backlash. We also found that nutrition confusion and backlash were negatively associated with exercise behaviour and fruit and vegetable consumption, respectively. CONCLUSIONS: Our study supports the theoretical pathways that explain the influence of CNI exposure on nutrition-related cognitive and behavioural outcomes. Additionally, different types of online information sources are associated with these outcomes to varying degrees. In the context of obesity and diabetes rates in the UK, our findings call for (a) further experimental research into the effects of CNI on consumers' diet-related cognitions and behaviours and (b) multi-stakeholder, interdisciplinary approaches to address this problem.

Barriers to older adults' uptake of mobile-based mental health interventions.

BACKGROUND: To address increasing demand of mental healthcare treatments for older adults and the need to reduce delivery costs, healthcare providers are turning to mobile applications. The importance of psychological barriers have been highlighted in the uptake of mobile-based mental health interventions and efforts have been made to identify these barriers in order to facilitate initial uptake and acceptance. However, limited research has focused on older adults' awareness of these applications and factors that might be hindering their use. OBJECTIVE: The purpose of this study was to explore the perceived barriers that older adults experience in the uptake of mobile-based mental health interventions. METHODS: Semi-structured interviews were conducted with a sample of 10 older adults, 50 years or older (female = 7, mean age = 68 years), who experienced periods of low mood. National Health Service applications were demonstrated to facilitate conversation and explore participants' understanding of mental health and mobile-based mental health interventions. Thematic analysis was used to analyse the interview transcripts. RESULTS: The social ecological model was adopted as an organising framework for the thematic analysis which identified six distinct barriers to older adults' uptake of mobile-based mental health interventions: mental electronic-health (e-health) awareness, interaction with technology, discontinuation, 'seeing' facilitates therapeutic alliance, incongruent role of the general practitioner and privacy and confidentiality. CONCLUSIONS: Older adults experience a number of barriers to uptake ranging from the individual level to a macro, organisational level. The practical implications of these barriers are discussed such as the need for increased awareness of mobile-based mental health interventions among older adults.

Enhancing organizational health literacy in a rural Missouri clinic: a qualitative case study.

PURPOSE: The purpose of this paper is to evaluate a collaborative effort between a health care organization and academic institution to strengthen organizational health literacy. DESIGN/METHODOLOGY/APPROACH: The intervention took place at a rural, federally qualified health clinic in Missouri between May 2009 and April 2011. Qualitative interviews of key informants were conducted before (n=35) and after (n=23) the intervention to examine program implementation and success in effecting organizational change. FINDINGS: Intervention activities helped establish a comprehensive understanding of health literacy. The project achieved moderate, fundamental and sustainable organizational change. The program successfully integrated health literacy practices into clinic systems and garnered leadership and organizational commitment, helped the workforce improve interpersonal communication and embedded practices making health education materials more accessible. ORIGINALITY/VALUE: The study points to programmatic, conceptual and methodological challenges that must be addressed for organizations to improve health literacy practices, and suggests change management strategies to advance organizational health literacy.

Outbreak communication challenges when misinformation spreads on social media / Desafios da comunicação de surtos epidêmicos quando a desinformação se espalha nas redes sociais / Desafíos en la comunicación de brotes epidémicos cuando se difunde información errónea en las redes sociales

This commentary analyses the implications of social media misinformation for global health risk communication. We define misinformation, describe the pathways through which it can adversely affect responses to risk communication efforts, highlight vulnerabilities in existing interventions and present an agenda for further research to understand and address this problem.

Este artigo analisa as implicações da desinformação nas mídias sociais para a comunicação global de riscos à saúde. Definimos desinformação, descrevemos os caminhos pelos quais ela pode afetar negativamente as respostas aos esforços de comunicação de risco, destacamos as vulnerabilidades nas intervenções existentes e apresentamos uma agenda para futuras pesquisas para entender e abordar esse problema.

Este artículo analiza las implicaciones de la desinformación en las redes sociales para la comunicación de riesgos de salud global. Definimos información errónea, describimos los caminos por los cuales puede afectar de manera adversa las respuestas a los esfuerzos de comunicación de riesgos, resaltamos las vulnerabilidades en las intervenciones existentes y presentamos una agenda para futuras investigaciones para comprender y abordar este problema.

Zika reveals India's risk communication challenges and needs.

India's approach to disseminating information about the first three cases of the Zika virus was criticised nationally and internationally after the issue came to light in May 2017 through a World Health Organization news release. We analyse the incident from a risk communication perspective. This commentary recaps the events and synthesises key arguments put forth by the news media and public health stakeholders. We use Peter Sandman's risk = hazard + outrage framework - also adopted by India's risk communication planners - to analyse India's risk communication response and contextualise it against the mandate of the National Risk Communication Plan and Integrated Disease Surveillance Programme. We conclude with recommendations for India's risk communication policymakers, including the need to develop capacity for risk communication research and scholarship in the country.

Virtual Zika transmission after the first U.S. case: who said what and how it spread on Twitter.

BACKGROUND: This paper goes beyond detecting specific themes within Zika-related chatter on Twitter, to identify the key actors who influence the diffusive process through which some themes become more amplified than others. METHODS: We collected all Zika-related tweets during the 3 months immediately after the first U.S. case of Zika. After the tweets were categorized into 12 themes, a cross-section were grouped into weekly datasets, to capture 12 amplifier/user groups, and analyzed by 4 amplification modes: mentions, retweets, talkers, and Twitter-wide amplifiers. RESULTS: We analyzed 3,057,130 tweets in the United States and categorized 4997 users. The most talked about theme was Zika transmission (~58%). News media, public health institutions, and grassroots users were the most visible and frequent sources and disseminators of Zika-related Twitter content. Grassroots users were the primary sources and disseminators of conspiracy theories. CONCLUSIONS: Social media analytics enable public health institutions to quickly learn what information is being disseminated, and by whom, regarding infectious diseases. Such information can help public health institutions identify and engage with news media and other active information providers. It also provides insights into media and public concerns, accuracy of information on Twitter, and information gaps. The study identifies implications for pandemic preparedness and response in the digital era and presents the agenda for future research and practice.

What's buzzing on your feed? Health authorities' use of Facebook to combat Zika in Singapore.

In 2016, Singapore grappled with one of the largest Zika outbreaks in Southeast Asia. This study examines the use of Facebook for Zika-related outreach by the Ministry of Health (MOH) and the National Environmental Agency (NEA) from March 1, 2015, to September 1, 2016, and public response to this effort. Despite nearly equivalent outreach, MOH's Facebook posts received more likes (µ = 3.49) and shares (µ = 30.11), whereas NEA's posts received more comments (µ = 4.55), with NEA posting mostly on prevention (N = 30) and MOH on situational updates (N = 24). Thematic analyses identified prevention-related posts as garnering the most likes (N = 1277), while update-related posts were most shared (N = 1059) and commented upon (N = 220). Outreach ceased briefly for 2 months after Singapore's first imported case of Zika, but increased following the outbreak of locally transmitted cases in August 2016. Public engagement was significantly higher during Zika compared with prior haze and dengue outbreaks. The results indicate the value of Facebook as a tool for rapid outreach during infectious disease outbreaks, and as a "listening" platform for those managing the situation. We discuss implications for public health communication research and policy.

Comparing State Legislative Aides' Perspectives on Tobacco Policymaking in States With Strong and Weak Policies: A Qualitative Study.

PURPOSE: The study compared perceptions of state legislative aides about tobacco policymaking in states with strong and weak tobacco control policies. APPROACH: Qualitative in-depth interviews carried out in 2009. SETTING: The US states were ranked on a combination of tobacco prevention funding, taxes, and presence of smoke-free policies. States at the top and bottom of the rankings were chosen. PARTICIPANTS: Interviews were conducted with 10 legislative aides in 5 states with strong tobacco control policies and 10 aides in 7 states with weak policies. METHOD: Twenty semistructured interviews were conducted, coded, and analyzed using a consensus coding process. RESULTS: Tobacco control was a lower priority in states with weak policies, and respondents from these states listed more barriers to tobacco control policymaking than those from states with strong policies. Successful arguments for tobacco control emphasized operational applications, for example, enhanced revenue from tobacco taxes or safety of children and employees. CONCLUSION: Our findings support propositions posited in the Advocacy Coalition Framework. They point to the preeminence of contextual factors, notably political leanings and economic climate on success of policy change efforts. Lessons learned from participants from states with strong policy nonetheless show promise for success in states with weak policy.

A Social Media mHealth Solution to Address the Needs of Dengue Prevention and Management in Sri Lanka.

BACKGROUND: Sri Lanka has witnessed a series of dengue epidemics over the past five years, with the western province, home to the political capital of Colombo, bearing more than half of the dengue burden. Existing dengue monitoring prevention programs are exhausted as public health inspectors (PHIs) cope with increasing workloads and paper-based modes of surveillance and education, characterizing a reactive system unable to cope with the enormity of the problem. On the other hand, the unprecedented proliferation and affordability of mobile phones since 2009 and a supportive political climate have thus far remained unexploited for the use of mobile-based interventions for dengue management. OBJECTIVE: To conduct a needs assessment of PHIs in Colombo with respect to their dengue-related tasks and develop a new mobile-based system to address these needs while strengthening existing systems. METHODS: One-on-one in-depth interviews were conducted with 29 PHIs to a) gain a nuanced, in-depth understanding of the current state of surveillance practices, b) understand the logistical, technological and social challenges they confront, and c) identify opportunities for mobile-based interventions. Quantitative analysis included simple descriptive statistics while qualitative analysis comprised textual analysis of 209 pages of transcripts (or nearly 600 minutes of conversations) using grounded theory approaches. RESULTS: Current paper-based data collection practices for dengue surveillance involved a circuitous, time consuming process that could take between 7-10 days to officially report and record a single case. PHIs confronted challenges in terms of unreliable, standalone GIS devices, delays in registering mosquito breeding sites and lack of engagement from communities while delivering dengue education. These findings, in concert with a high motivation to use mobile-based systems, informed the development of Mo-Buzz, a mobile-based system that integrates three components - digitized surveillance, dynamic disease mapping and digitized dengue education - on a common platform. The system was developed through an iterative, evolutionary, collaborative process, consistent with the Spiral model of software development and is currently being used by all 55 PHIs in the CMC system. CONCLUSIONS: Given the entrenched nature of existing paper-based systems in PHIs' work habits, we expect a gradual adoption curve for Mo-Buzz in the future. Equally, we expect variable adoption of the system with respect to its specific components, and specific PHI sub-groups (younger versus older). The Mo-Buzz intervention is a response to multiple calls by the global mHealth community for collaborations in the area of mobile interventions for global health. Our experience revealed that the benefits of this paradigm lies in alleviating country-specific public health challenges through a commonly shared understanding of cultural mores, and sharing of knowledge and technologies. We call upon future researchers to further dissect the applicability of the Spiral Model of software development to mHealth interventions and contribute to the mHealth evidence debate from theoretical and applied perspectives.

Baseline Evaluation of a Participatory Mobile Health Intervention for Dengue Prevention in Sri Lanka.

Challenges posed by infectious disease outbreaks have led to a range of participatory mobile phone-based innovations that use the power of crowdsourcing for disease surveillance. However, the dynamics of participatory behavior by crowds in such interventions have yet to be examined. This article reports results from a baseline evaluation of one such intervention called Mo-Buzz, a mobile-based crowdsource-driven socially mediated system developed to address gaps in dengue surveillance and education in Colombo, Sri Lanka. We conducted a 30-minute cross-sectional field survey (N = 404) among potential users of Mo-Buzz in Colombo. We examined individual, institutional, and cultural factors that influence their potential intention-to-use Mo-Buzz and assessed if these factors varied by demographic factors. Descriptive analysis revealed high perceived ease-of-use (PEOU; M = 3.81, SD = 0.44), perceived usefulness (PU; M = 4.01, SD = 0.48), and intention-to-use (PI; M = 3.91, SD = 0.46) among participants. Analysis of variance suggested participants in the 31 to 40 years age group reported highest PEOU, whereas the oldest group reported high perceived institutional efficacy (M = 3.59, SD = 0.64) and collectivistic tendencies. Significant differences (at the p < .05 level) were also found by education and income. Regression analysis demonstrated that PU, behavioral control, institutional efficacy, and collectivism were significant predictors of PI. We concluded that despite high overall PI, future adoption and use of Mo-Buzz will be shaped by a complex mix of factors at different levels of the public health ecology. Implications of study findings from theoretical and practical perspectives related to the future adoption of mobile-based participatory systems in public health are discussed and ideas for a future research agenda presented.