With an intersectional orientation, we examine associations between discrimination, health communication, and information-seeking intention about HIV prevention in the context of pre-exposure prophylaxis (PrEP) among cisgender women through an online survey ( = 341). We elaborate on the idea that intersectional discrimination is a social determinant of health by considering the context with differing power relations-day-to-day life and the healthcare field-based on Bourdieu's field theory, and explore moderating roles of health communication in this relationship according to the structural influence model of communication (SIM). The relationships between intersectional discrimination and intention show different patterns by the in which intersectional experiences are considered, and the relationships are moderated differently by the of health communication. We discuss how to conduct intersectionality-informed health communication research without sacrificing intersectionality's foundational foci.

When stories have undesirable endings, readers often engage in replotting, meaning they imagine alternative plotlines that could change the unwanted ending. Recent research has found that both the cognitive and emotional components of replotting serve as mechanisms of narrative persuasion. Building on this work, the current study assessed if people who habitually replot are more persuaded by a tragic story ending than those who do not, testing hypotheses with melanoma narratives. Cognitive and emotional (i.e., anger, anxiety, sadness, and hope) aspects of replotting were tested as mechanisms of this proposed interaction. Participants ( = 432) were randomized into a 2 (protagonist death vs. survival) x 6 (specific melanoma story) between-subjects online narrative message experiment. Participants who habitually replot had significantly higher melanoma prevention intentions after reading a death (compared to a survival) ending. This effect was not present for other participants. However, counter to hypotheses, the cognitive and emotional aspects of actual replotting did not explain the effect, meaning habitual replotters were not more likely to replot the death ending or experience replotting emotion than other participants were. Future research is needed to determine why habitual replotters are more persuaded by unwanted story endings than other audience members are.

In our research, we examined how three dimensions of opinion leadership-connectivity, maven, and persuasiveness-are associated with sharing positive and negative information about vaccines among parents in Hong Kong through a mixed-methods approach. In two studies, we assessed opinion leadership following a sociometric approach that involved using data from social media (Study 1) and a self-assessment using survey data (Study 2), which yielded largely consistent results. In particular, whereas connectivity and maven were significantly associated with sharing positive information about vaccines, all three dimensions were significantly associated with sharing negative information about vaccines. Those findings suggest that different dimensions of opinion leadership play different roles in information sharing depending on the information's valence. Moreover, the similar pattern of findings from both studies suggested that the sociometric approach and self-assessment may capture the multidimensional nature of opinion leadership equally well. In sum, the findings advance theoretical discussions on the role of opinion leadership in information sharing and offer practical insights into promoting vaccination for children among parents.

The current study investigated the effectiveness of factual and narrative messages in promoting advocacy intentions among viewers of COVID-19 vaccination messaging. In an online posttest only experiment on Qualtrics online software, participants ( = 323) were randomly assigned to one of four conditions related to type of messaging (i.e. factual, narrative, both, control). The final model revealed that both types of messages work in generating advocacy but through two distinct influential pathways. Moreover, a message containing both facts and a narrative proved to be more effective than a message containing only a narrative or only facts.

In a secondary analysis, we examine how trust in pro-recommendation versus alternative communication channels mediated effects of demographic, personality, lifestyle, and political variables on COVID-19 protective behavior in England. In so doing, we adapt the media-as-mediator approach to the pandemic context. Respondents reported that family, close friends, primary care medical providers, and mainstream news media were relatively supportive of public health recommendations, and social media friend networks, faith/community groups, alternative news sites, and alternative health practitioners were relatively unsupportive. Parallel mediation analyses showed that effects of age, dutiful civic-mindedness, sensation-seeking, healthy lifestyle orientation, and more marginally, race on COVID-19 protective behavior were mediated by trust in these pro-recommendation and/or alternative communication channels. In some cases, trust in exemplars of both types of channels resulted in these channels influences largely canceling one another out.

Our team developed (CCAs), a tool to help adolescents and health care providers (HCPs) communicate and collaboratively set behavior change goals. The objectives of this pilot randomized controlled trial were to test the feasibility, user experience, and preliminary effect of using CCAs with adolescents in primary care, focusing on behavior change and collaborative goal setting among adolescents. From March 2019 to September 2022, adolescents were recruited from the Northeast Community Health Centre (Edmonton, AB). Adolescents were randomized (1:1) to one of two groups: CCA + goal setting (experimental group) or goal setting alone (control group). Data were collected from both groups at baseline and at 3-weeks post-baseline. In total, 31 adolescents completed the trial (terminated early due to COVID-19). The study demonstrated high practicality. Adolescents reported positive user experiences with CCAs, citing attractiveness, clarity, efficiency, and dependability. No group differences were detected for behavior changes at 3-weeks post-baseline ( > .05), although adolescents in the experimental group qualitatively described improved rapport and communication with HCPs. CCAs can be used practically in a primary health care setting to facilitate communication and rapport with adolescents; however, their effect in enabling behavior change should be investigated in a multi-site, larger-scale trial.

To examine the effects of numerical evidence and message framing in communicating vaccine efficacy information about infectious diseases, an online experiment presented to U.S. adults different versions of a vaccination promotional message that vary by numerical vaccine efficacy evidence: (low efficacy rate: 60% vs. high efficacy rate: 95%), outcome framing (preventing disease-related infection vs. preventing disease-related severe illness), and gain vs. loss framing, using a factorial between-subjects design. While there was no significant interaction between numerical vaccine efficacy evidence and message framing, findings showed that a higher vaccine efficacy rate increased positive beliefs about vaccination and outcome framing emphasizing infection prevention increased message processing fluency. Given that infectious diseases pose higher risks for severe illness among older adults, follow-up analyses by age showed that only younger adults were sensitive to message framing where outcome framing emphasizing infection prevention increased processing fluency.

Media coverage of depression on social media with specific framings could shape people's perception and attitude, which is significant in reducing the stigma and promoting support for depression sufferers. Adopting the lens of moral foundation theory (MFT), this study aims to explore the effect of inherent moral framings within depression coverage on social media on the stigma and approval attitudes toward depression in audiences' responses. A large language model and a dictionary-based approach were respectively adopted to score depression-related media coverages ( = 919) and corresponding comments ( = 92,505) collected from the Weibo platform against MFT's five dimensions and (de)stigma attitudes. The results indicated that care, purity, and fairness framings are prevalent in depression coverage, surpassing moral framings such as betrayal, harm, and cheating. Most responses expressed approval rather than stigma. Moreover, the use of care and loyalty framings can elicit approval responses but decrease audience engagement.

With COVID-19 vaccination rates remaining below optimal levels, scalable interventions to shift vaccination intentions are needed. We embedded two randomized experiments in South Africa's COVID-19 Vaccine Survey (CVACS) to investigate the potential to change vaccine intentions and behavior. In Experiment 1, 3510 unvaccinated South African adults were randomly assigned to a no-message control group, a social norm message, or a message highlighting that vaccines were free, available and easy to obtain. The free and easy message significantly increased vaccine intentions but did not increase other outcome measures. The social proof message was associated with an increase in self-reported vaccination status at follow-up (not significant at traditional statistical thresholds). In Experiment 2, 3608 unvaccinated South African adults were randomly assigned to a no-message control group, a message highlighting gaining greater freedoms, or a message highlighting being part of the solution to the pandemic. Neither value proposition message increased vaccination intentions. Light-touch and scalable messages informed by behavioral science and social marketing principles may increase vaccination intentions and uptake, However, more attention should be paid to understanding the behavioral barriers experienced by different population segments, and to tailoring and targeting messaging to those barriers and segments.

Young people account for over half of new STI cases and youth of color face increased sexual health disparities. In partnership with Fact Forward, researchers conducted qualitative formative audience research to develop a culture-centered health communication campaign to increase access to and use of sexual health services among youth of color in South Carolina. Grounded in a reproductive justice theoretical framework, this study employed innovative strategies, including training youth ambassadors to moderate peer-to-peer focus groups. A total of 134 participants were recruited for the study with 51 individuals participating in 9 focus groups and 83 respondents completing a web-based survey (ages 15-24). Qualitative data analyses used Nvivo 1.5.1. Statistical analyses used R Studio®. Findings revealed barriers including lack of education about risks. Participants identified dimensions of inequity and the importance of intersectional messaging to address intimacy, sexuality, and trust. They emphasized normalizing conversations about sexual health and the need for important others "in your corner" to provide support. Participants suggested an empowering storytelling approach to reduce shame surrounding sexual health services. Social media emerged as an optimal communication channel. UNC Perceived Message Effectiveness (PME) Scale scores ranged from 4.42 to 4.57 (out of 5) indicating that messages were well received by participants. Sex-positive campaign messaging focused on self-love, empowerment, and taking control of sexual health. This study offers practical suggestions to develop effective communication strategies to reach youth of color to increase use of sexual health services, including contraceptive counseling, STI prevention, screening, and treatment.

Despite the robust scientific evidence affirming the safety and efficacy of COVID-19 vaccines, the proliferation of misinformation on social media platforms poses a threat by potentially exacerbating vaccine hesitancy. In response, certain social media platforms have taken measures to flag posts containing such misinformation with warning labels, aiming to dispel false beliefs. This present study employs a survey experiment ( = 304) to examine the effectiveness of two distinct warning labels - disputed and neutral warning labels - in the Twitter (the social media platform now known as X) context, specifically targeting misinformation about COVID-19 vaccines. This study investigates the nuanced effects of vaccine hesitancy on the perceived credibility of debunked misinformation posts following the application of warning flags. The results demonstrated that disputed labels significantly reduced the perceived credibility of misinformation regarding anti-COVID-19 vaccines in comparison to posts without any labeling. Nevertheless, individuals exhibiting higher levels of vaccine hesitancy tended to view the misinformation as more credible than their counterparts with lower levels of hesitancy. These findings present the efficacy of warning labels in combatting misinformation on social media platforms, particularly among those who are least hesitant about vaccination.

HPV-associated cancer disparities disproportionately affect Black/African American and Hispanic individuals in the U.S. HPV vaccination, which can prevent many HPV-associated cancers, should be clearly recommended by pediatricians to parents of adolescents aged 9-12, yet uptake and completion remain lower than other adolescent vaccinations. We used the Structural Influence Model of Health Communication to explore communication inequalities from interviews with 19 Black and Hispanic mothers of adolescents. We identified HPV vaccination information seeking behaviors, media use, and preferred channels to address information needs. This study provides insights into how mothers' nativity and ethno-racial identity influenced how they accessed and processed information from various sources. Preferences for digital and community-based strategies to address information gaps and hesitancy concerns are also presented. Findings suggest future prevention strategies must increase access to accurate information that resonates with NH-Black and Hispanic communities' needs and is disseminated via preferred communication channels to maximize the effects of multi-level interventions promoting HPV vaccination among communities experiencing disparities.

This study examined how message themes, frames, and sources in vaping cessation videos on TikTok influenced positive (i.e. likes, shares, positive comments regarding quitting vaping) and negative video engagement (i.e. negative comments regarding quitting vaping). TikTok videos ( = 412) with the hashtags #quitvaping and #quittingvaping were analyzed. Aspect-based sentiment analysis was conducted to evaluate the sentiment of quitting vaping in comments. Negative binomial regression models predicted video engagement from six message themes, ratios of gain and loss frames, and message sources. Themes related to nicotine addiction and physical health effectively drove positive engagement, such as likes and shares. The theme of harmful chemicals elicited mixed responses, generating both positive and negative comments regarding quitting vaping. Videos with a higher ratio of gain frames led to more positive engagement, including likes, shares, and positive comments regarding quitting vaping. Sources with informal expertise (e.g. those who have successfully quit vaping) and current e-cigarette users were more effective in engaging the TikTok audience than non-expert and non-user sources. These findings provide insights into messaging strategies that can effectively engage TikTok audiences and encourage vaping cessation.

In 2021, vaccination against COVID-19 became mandatory for healthcare workers in England. The media coverage of the mandate was extensive and became an issue of public interest. This study aimed to understand the United Kingdom (UK) debate on mandatory COVID-19 vaccination through a framing analysis of UK media coverage. Articles written between November 2021 and April 2022 were identified from UK national newspapers: The Daily (and Sunday) Telegraph, the Times (and Sunday Times), the Guardian (and the Observer), the Independent, the Daily Mail (and Mail on Sunday), the Daily Mirror, the Daily Express, and the Sun. Articles were selected using eligibility criteria before framing analysis was undertaken. The sample included 204 articles. Safe Staffing, Treatment of Staff, Change in Covid Context, and Protect Patient Safety were identified as frames used to stimulate debate on the mandatory vaccination policy. Such frames established three broader concepts in the media: civil liberty theory, duty-based ethics, and social-vulnerability theory. This study analyzed how mandatory COVID-19 vaccination for healthcare workers in England was framed in the UK national media. The broader concepts built in the media heightened debate on the policy, creating a voluminous amount of coverage and criticism that may have played a role in the mandate's reversal.

Public health campaigns addressing COVID-19 vaccination beliefs may be effective in changing COVID-19 vaccination behaviors, particularly among people who remain vaccine hesitant. The "" COVID-19 public education campaign (the Campaign) was designed to increase COVID-19 vaccine confidence and uptake. This study aims to evaluate whether Campaign dose was associated with changes in vaccination beliefs related to COVID-19 vaccine concerns and perceived risks, the importance of COVID-19 vaccines, the perceived benefits of COVID-19 vaccination, normative beliefs about COVID-19 vaccination, and perceptions about general vaccine safety and effectiveness. The study linked data from four waves of a nationally representative longitudinal panel of U.S. adults (January 2021-March 2022) with Campaign paid digital media data (April 2021-May 2022). We used mixed-effects linear regressions to examine the association between Campaign paid digital impressions and changes in vaccination beliefs. The results provide evidence that Campaign digital impressions were significantly associated with changes in respondent beliefs regarding COVID-19 vaccine concerns and perceived risks, perceived benefits of COVID-19 vaccination, and perceptions about general vaccine safety and effectiveness. Findings suggest that public education campaigns may influence vaccine confidence and uptake by increasing positive vaccination beliefs and reducing vaccine concerns.

Patient-centered communication (PCC) is considered a key component of quality healthcare, with reported levels of PCC rising over the last decade. However, engagement with patient emotions and uncertainty have been slower to rise, and healthcare providers at times use PCC behaviors to manipulate patients. Healthcare providers' use of the communication theory of resilience's (CTR) processes could benefit patients. A cross-sectional survey in the United States ( = 486) tested associations between CTR processes and patient satisfaction and perceived physical and mental health. All five core CTR processes were positively correlated with patient outcomes. When controlling for traditional PCC behaviors: (a) crafting normalcy, identity anchors, and alternative logics were positively related to patient satisfaction, (b) no processes were related to perceived mental health, and (c) communication networks, alternative logics, and productive action were positively related to perceived physical health. Condition severity moderated three associations. At moderate-high severity, crafting normalcy and communication networks were positively related to perceived mental health, and crafting normalcy was positively related to perceived physical health. Findings extend CTR into the patient-provider relationship and demonstrate the practical potential of CTR processes for improving patient outcomes. The study also forwards a measure of healthcare provider resilience communication (HPRC).

This research examined the themes that emerge from online discussions of the COVID-19 vaccines to assist health communicators and officials in combating misinformation in health-related discussions. Using framing theory and the diffusion of innovation framework, this study presents findings from a semantic network analysis of 3842 tweets collected during the first week of February 2022. The authors calculated betweenness and page rank centrality scores for Twitter users participating in the online dialogue and identified 36 semantic themes. Findings revealed that the most influential dialogue participants were retired health and medical professionals, data analysts, journalists, online advocates, and politicians. The frames identified in the study contained several misinformation narratives about the COVID-19 vaccines. The authors discuss the implications of these findings for health officials and communicators as well as the theoretical implications of the diffusion of misinformation and framing as a tool to reiterate untruths.

Government health messaging is significant to the containment of public health crises. Such communication may benefit from using fear appeal, a message strategy for promoting health and preventing diseases. Yet little scholarly attention has been paid to how fear appeal is employed in government messaging to promote social media engagement through online actions including likes, shares, and comments. These actions play a meaningful role in addressing communication exigencies within the context of health crises. In this study, quantitative content analysis and corpus linguistics methods were employed to analyze fear appeal-related elements in COVID-19 messages sent by a state-owned media outlet on social media. The results show that when compared to messages without threat, messages conveying threat elicited significantly more comments, in which emotions and perceptions to threat and efficacy were exhibited, while messages containing both threat and efficacy generated more engagement in comparison to messages with threat alone. Moreover, while subdimensions under efficacy were positive predictors of engagement, those under threat were primarily found to have exerted negative effects. The findings provide insights into how fear appeal elements can be employed in government health crisis communication to engage the public.

Autoimmune disease disproportionately afflicts women of color (i.e., Black/African American, Hispanic/Latina, Multiethnic-racial) of childbearing age. Social determinants of health (SDOH) and dismissive healthcare provider (HCP) interactions exacerbate these disparities in health outcomes for women of color with autoimmune disease. Guided by the theory of communicative (dis)enfranchisement, this study assesses whether disenfranchising talk (DT) mediates the relationship between SDOH (i.e., race/ethnicity, insurance status, income, employment, education, and sexual orientation) and health outcomes including patient satisfaction, overall well-being, and tangible social support for women of color with autoimmune disease. Findings affirmed the mediating role of DT, such that Multiethnic-racial patients and those with less insurance coverage and lower household income reported less tangible social support, poorer overall well-being, and lower patient satisfaction when they experienced HCP DT. We offer theoretical and practical implications.