US state vaccine mandates did not influence COVID-19 vaccination rates but reduced uptake of COVID-19 boosters and flu vaccines compared to bans on vaccine restrictions.

During the COVID-19 pandemic, some US states mandated vaccination for certain citizens. We used state-level data from the CDC to test whether vaccine mandates predicted changes in COVID-19 vaccine uptake, as well as related voluntary behaviors involving COVID-19 boosters and seasonal influenza vaccines. Results showed that COVID-19 vaccine adoption did not significantly change in the weeks before and after states implemented vaccine mandates, suggesting that mandates did not directly impact COVID-19 vaccination. Compared to states that banned vaccine restrictions, however, states with mandates had lower levels of COVID-19 booster adoption as well as adult and child flu vaccination, especially when residents initially were less likely to vaccinate for COVID-19. This research supports the notion that governmental restrictions in the form of vaccination mandates can have unintended negative consequences, not necessarily by reducing uptake of the mandated vaccine, but by reducing adoption of other voluntary vaccines.

An Investigation into the Portrayal of Organ Donation on Grey's Anatomy Seasons 1 Through 15.

The current project sought to extend prior research examining organ donation portrayals on Grey's Anatomy by examining the first fifteen seasons. Guided by the health belief model, content analysis revealed more attention was given to benefits of donation than barriers. Contrary to previous research, more attention was given to refuting rather than promoting commonly cited myths. The results also address attention to the health threat as well as Grey's Anatomy's representation of self-efficacy in registering to be an organ donor. Finally, proportion tests revealed significant differences between the types of organs transplanted on Grey's Anatomy compared to organs transplanted in the United States. The results are discussed with an emphasis on portrayal trends throughout Season 1 through 15 as well as the theoretical and practical implications of our findings.

Comprehensive Model of Information Seeking: A Meta-Analysis.

The comprehensive model of information seeking (CMIS) is a well-known framework to predict health information seeking by a combination of health beliefs and medium-related factors. Despite being proposed almost three decades ago, few efforts have been made to systematically summarize CMIS scholarship. To fill this gap in the literature, 36 meta-analyses were first conducted to identify the bivariate relationships between variables in the CMIS. These meta-analytic data were then used to test path models evaluating the role of health beliefs and medium-related factors. The results showed that the models containing only factors related to the communication medium, only health factors, and a modified version of the CMIS fit the data relatively well. The original CMIS did not demonstrate an acceptable model fit. Theoretical and practical implications are discussed.

Psycholinguistic Markers of COVID-19 Conspiracy Tweets and Predictors of Tweet Dissemination.

The adoption of conspiracy theories about COVID-19 has been fairly widespread among the general public and associated with the rejection of self-protective behaviors. Despite their significance, however, a gap remains in our understanding of the underlying characteristics of messages used to disseminate COVID-19 conspiracies. We used the construct of resonance as a framework to examine a sample of more than 1.8 million posts to Twitter about COVID-19 made between April and June 2020. Our analyses focused on the psycholinguistic properties that distinguish conspiracy theory tweets from other COVID-19 topics and predict their spread. COVID-19 conspiracy tweets were distinct and most likely to resonate when they provided explanations and expressed negative emotions. The results highlight the sensemaking functions served by conspiracy tweets in response to the profound upheaval caused by the pandemic.

The Effectiveness of Social Norm Appeals on Promoting COVID-19 Prevention Behaviors: A Multistudy Examination.

Recent research shows social norm perceptions predict people's adherence to COVID-19 preventative health practices. Nonetheless, additional empirical studies are necessary to evaluate the effectiveness of different types of social norm messages on behavioral outcomes with experimental designs. Guided by the social norm literature and frameworks, the current research addresses this need by examining the effects of descriptive and injunctive norm appeals promoting the practice of social distancing and mask-wearing with both a controlled experiment and social media campaigns. Results from this multistudy investigation showed the effectiveness of descriptive and injunctive norm messages (v. no message exposure) in promoting focal behaviors and highlighted the superiority of injunctive norm appeals in promoting behavioral intentions and increasing social media engagement. Theoretical implications and recommendations for practice are discussed.

Russian Troll Vaccine Misinformation Dissemination on Twitter: The Role of Political Partisanship.

Although vaccine misinformation has been a longstanding problem, the growth of social media and divides based on political ideology have raised novel concerns. One noteworthy example involves the Russian Internet Research Agency's deployment of operatives on Twitter (i.e., trolls) working to sow discord among the American public. We examine 1,959 tweets made by trolls between 2015 and 2017 about vaccination to better understand their efforts to spread vaccine misinformation. Our results indicate that misinformation was more likely to be perpetuated by left and right trolls than nonpartisan trolls. There was, however, relatively little user engagement with vaccine tweets containing misinformation and no differences in engagement with misinformation shared by partisan and nonpartisan trolls. Trends in the psycholinguistic properties of language in trolls' vaccine tweets suggest that right and left trolls were more likely to include cognitive process words (i.e., insight, causation, discrepancy, certainty, differentiation, and tentativeness) than were nonpartisan trolls.

Psychological Reactance Theory and COVID-19 Vaccine Mandates: The Roles of Threat Magnitude and Direction of Threat.

The current study examines psychological reactance theory (PRT), focusing on the role of threat directness and threat magnitude in the context of a COVID-19 vaccine mandate. Students on two college campuses in the United States (N = 374) were informed that their university or the other university (i.e., threat directness manipulation) was considering a vaccinate mandate for the following semester that would or would not include sanctions for noncompliance (i.e., threat magnitude manipulation). Participants experienced significantly greater freedom threat perceptions when the mandate included sanctions compared to when it did not, but freedom threat perception did not differ when the mandate was on their own campus as to the other campus. An interaction effect was also observed in which perceived freedom threat and reactance was greatest among participants receiving an indirect (as opposed to direct) threat with sanctions. Findings are discussed with an emphasis on the theoretical contribution to PRT along with the practical implications for vaccine mandates.

Social Enhancement and Compensation in Online Social Support among Cancer Patients: The Role of Social Network Properties.

Although several researchers have reported evidence that the benefits of Internet use depend on users' offline resources, the factors responsible for this phenomenon are not well understood. We examined a network-based explanation for social enhancement (i.e., rich get richer) and social compensation (i.e., poor get richer) in the context of received social support among adults coping with cancer. After first controlling for support received offline, we tested the role of two offline network properties in predicting support received online. The results were mostly consistent with social enhancement. Offline group affiliation was associated with greater levels of support received online. Additionally, significant indirect effects were observed from offline group affiliation to support received online through online group affiliation as well as from offline tie strength to support received online through online tie strength.

Big Data, Computational Social Science, and Health Communication: A Review and Agenda for Advancing Theory.

Contemporary research on health communication has been marked by the presence of big data and computational social science (CSS) techniques. The relative novelty of these approaches makes it worthwhile to consider their status and potential for advancing health communication scholarship. This essay offers an introduction focusing on how big data and CSS techniques are being employed to study health communication and their utility for theory development. Key trends in this body of research are summarized, including the use of big data and CSS for examining public perceptions of health conditions or events, investigating network-related dimensions of health phenomena, and illness monitoring. The implications of big data and CSS for health communication theory are also evaluated. Opportunities presented by big data and CSS to help extend existing theories and build new communication theories are discussed.

The Paradoxical Outcomes of Observing Others' Exercise Behavior on Social Network Sites: Friends' Exercise Posts, Exercise Attitudes, and Weight Concern.

This study examined the implications of observing others' exercise behavior on social network sites (SNSs). Social cognitive theory and social comparison theory were used to make predictions about the conditions under which individuals' (N = 232) exposure to exercise-related SNS posts from others in their social network were related to their weight concerns and exercise attitudes. The results revealed a paradox in which observing others' exercise posts was associated with both adaptive and maladaptive responses. The number of exercise-related SNS posts received from members of respondents' social networks was associated with greater weight concern, and this relationship was stronger among respondents who viewed exercise-related posts from network members who were similar to respondents. Yet, among respondents who had a tendency to make appearance-related upward social comparisons, the number of others' exercise-related SNS posts received was associated with pro-exercise attitudes.

A Test of The Risk Perception Attitude Framework as a Message Tailoring Strategy to Promote Diabetes Screening.

The risk perception attitude (RPA) framework was tested as a message tailoring strategy to encourage diabetes screening. Participants (N = 602) were first categorized into one of four RPA groups based on their diabetes risk and efficacy perceptions and then randomly assigned to receive a message that matched their RPA, mismatched their RPA, or a control message. Participants receiving a matched message reported greater intentions to engage in self-protective behavior than participants who received a mismatched message or the control message. The results also showed differences in attitudes and behavioral intentions across the four RPA groups. Participants in the responsive group had more positive attitudes toward diabetes screening than the other three groups, whereas participants in the indifferent group reported the weakest intentions to engage in self-protective behavior.

Health Blogging and Social Support: A 3-Year Panel Study.

The reported study explored the implications of informal computer-mediated social support for the well-being of individuals coping with illness over the course of 3 years. A panel study was conducted in which respondents--bloggers writing about their experiences living with a health condition--reported on their perceptions of social support and well-being during 2010 and again during 2013. Among respondents who completed both questionnaires (n = 49), increases in support availability from family and friends were related to improvements in bloggers' health self-efficacy as well as improvements in bloggers' loneliness, particularly among those who also experienced increased support availability from blog readers. Increased blog reader support availability was associated with improvements in bloggers' health-related uncertainty. Among respondents who completed the initial questionnaire (N = 121), a survival analysis showed that neither support available from family and friends nor support from blog readers predicted continued health blogging over the 3-year period.

Information Seeking in Uncertainty Management Theory: Exposure to Information About Medical Uncertainty and Information-Processing Orientation as Predictors of Uncertainty Management Success.

Uncertainty management theory outlines the processes through which individuals cope with health-related uncertainty. Information seeking has been frequently documented as an important uncertainty management strategy. The reported study investigates exposure to specific types of medical information during a search, and one's information-processing orientation as predictors of successful uncertainty management (i.e., a reduction in the discrepancy between the level of uncertainty one feels and the level one desires). A lab study was conducted in which participants were primed to feel more or less certain about skin cancer and then were allowed to search the World Wide Web for skin cancer information. Participants' search behavior was recorded and content analyzed. The results indicate that exposure to two health communication constructs that pervade medical forms of uncertainty (i.e., severity and susceptibility) and information-processing orientation predicted uncertainty management success.

An examination of the relationships among uncertainty, appraisal, and information-seeking behavior proposed in uncertainty management theory.

Uncertainty management theory (UMT; Brashers, 2001, 2007) is rooted in the assumption that, as opposed to being inherently negative, health-related uncertainty is appraised for its meaning. Appraisals influence subsequent behaviors intended to manage uncertainty, such as information seeking. This study explores the connections among uncertainty, appraisal, and information-seeking behavior proposed in UMT. A laboratory study was conducted in which participants (N = 157) were primed to feel and desire more or less uncertainty about skin cancer and were given the opportunity to search for skin cancer information using the World Wide Web. The results show that desired uncertainty level predicted appraisal intensity, and appraisal intensity predicted information-seeking depth-although the latter relationship was in the opposite direction of what was expected.

Health information seeking and the World Wide Web: an uncertainty management perspective.

Uncertainty management theory was applied in the present study to offer one theoretical explanation for how individuals use the World Wide Web to acquire health information and to help better understand the implications of the Web for information seeking. The diversity of information sources available on the Web and potential to exert some control over the depth and breadth of one's information-acquisition effort is argued to facilitate uncertainty management. A total of 538 respondents completed a questionnaire about their uncertainty related to cancer prevention and information-seeking behavior. Consistent with study predictions, use of the Web for information seeking interacted with respondents' desired level of uncertainty to predict their actual level of uncertainty about cancer prevention. The results offer evidence that respondents who used the Web to search for cancer information were better able than were respondents who did not seek information to achieve a level of uncertainty commensurate with the level of uncertainty they desired.

The implications of stigma and anonymity for self-disclosure in health blogs.

The reported study examines the implications of anonymity and stigma in the form of illness-related embarrassment for self-disclosure in the context of health blogging. Drawing from theorizing about anonymous communication and stigma, anonymity is argued to be strategically used by individuals who are embarrassed by their illness and to moderate the relationship between embarrassment and self-disclosure. Data from 114 individuals who blog about their experiences coping with a health condition were examined to test study hypotheses. Illness-related embarrassment was positively associated with anonymity. Additionally, anonymity moderated the relationship between embarrassment and self-disclosure. Among bloggers with relatively higher levels of anonymity, illness-related embarrassment was positively associated with self-disclosure. The results suggest that anonymity is strategically used and fosters self-disclosure among individuals who are embarrassed by their illness.

Weak tie support preference and preferred coping styles as predictors of perceived credibility within health-related computer-mediated support groups.

Drawing upon an optimal matching model framework, this study examined weak tie support preference and coping style as predictors of credibility perceptions among members of health-related computer-mediated support groups. One hundred and thirty-five participants from various health-related online support groups responded to a survey questionnaire. The results indicated that increases in weak tie support network preference and problem-focused coping scores predicted increases in perceptions of credibility of online support group members. However, emotion-focused coping was not a significant predictor of perceived credibility. The implications of these findings for weak tie support network, coping, and credibility theories are discussed along with limitations of the study and directions for future research.

Effects of Added Emphasis and Pause in Audio Delivery of Health Information.

Health literacy is crucial to supporting good health and is a major national goal. Audio delivery of information is becoming more popular for informing oneself. In this study, we evaluate the effect of audio enhancements in the form of information emphasis and pauses with health texts of varying difficulty and we measure health information comprehension and retention. We produced audio snippets from difficult and easy text and conducted the study on Amazon Mechanical Turk (AMT). Our findings suggest that emphasis matters for both information comprehension and retention. When there is no added pause, emphasizing significant information can lower the perceived difficulty for difficult and easy texts. Comprehension is higher (54%) with correctly placed emphasis for the difficult texts compared to not adding emphasis (50%). Adding a pause lowers perceived difficulty and can improve retention but adversely affects information comprehension.

LGBTQ+ inequity in crowdfunding cancer costs: The influence of online reach and LGBTQ+ state policy.

BACKGROUND: Emerging literature suggests that LGBTQ+ cancer survivors are more likely to experience financial burden than non-LGBTQ+ survivors. However, LGBTQ+ cancer survivors experience with cost-coping behaviors such as crowdfunding is understudied. METHODS: We aimed to assess LGBTQ+ inequity in cancer crowdfunding by combining community-engaged and technology-based methods. Crowdfunding campaigns were web-scraped from GoFundMe and classified as cancer-related and LGBTQ+ or non-LGBTQ+ using term dictionaries. Bivariate analyses and generalized linear models were used to assess differential effects in total goal amount raised by LGBTQ+ status. Stratified models were run by online reach and LGBTQ+ inclusivity of state policy. RESULTS: A total of N = 188,342 active cancer-related crowdfunding campaigns were web-scraped from GoFundMe in November 2022, of which N = 535 were LGBTQ+ and ranged from 2014 to 2022. In multivariable models of recent campaigns (2019-2022), LGBTQ+ campaigns raised $1608 (95% CI: -2139, -1077) less than non-LGBTQ+ campaigns. LGBTQ+ campaigns with low (26-45 donors), moderate (46-87 donors), and high (88-240 donors) online reach raised on average $1152 (95% CI: -$1589, -$716), $1050 (95% CI: -$1737, -$364), and $2655 (95% CI: -$4312, -$998) less than non-LGBTQ+ campaigns respectively. When stratified by LGBTQ+ inclusivity of state level policy states with anti-LGBTQ+ policy/lacking equitable policy raised on average $1910 (95% CI: -2640, -1182) less than non-LGBTQ+ campaigns from the same states. CONCLUSIONS AND RELEVANCE: Our findings revealed LGBTQ+ inequity in cancer-related crowdfunding, suggesting that LGBTQ+ cancer survivors may be less able to address financial burden via crowdfunding in comparison to non-LGBTQ+ cancer survivors-potentially widening existing economic inequities.