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McKenzie AH, Avshman E, Shegog R, Savas LS, Shay LA. Facebook's shared articles on HPV vaccination: analysis of persuasive strategies. BMC Public Health 2024; 24:1679. [PMID: 38915043 PMCID: PMC11197343 DOI: 10.1186/s12889-024-19099-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 06/11/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND The current study analyzed articles shared on Facebook between 2019 and 2021 that discuss the HPV vaccine. Results address a gap in knowledge about the persuasive strategies used in HPV vaccine discourse on Facebook. METHODS Using Buzzsumo.com, we collected 138 articles, shared on Facebook between 2019 and 2021, with the highest "engagement scores," or total number of reactions, comments, and shares. Using a content analysis methodology, three independent coders were trained in using the study codebook, achieved acceptable inter-rater reliability (Krippendorf's alpha = 0.811), and coded each article in Atlas.ti. RESULTS Seventy-two articles had a positive valence toward the HPV vaccine, 48 had a negative valence, and 18 were mixed-valence or neutral. Pro-vaccine articles presented a variety of evidence types in support of benefits of HPV vaccination. Pro-vaccine articles primarily originated from national and local news sources. Anti-vaccine articles combined presentation of evidence with persuasive arguments and strategies, such as mistrust of institutions, fear appeals, ideological appeals, presenting a high number of arguments or detail, and minimizing the severity of HPV. Three sources were responsible for producing 62.5% of all anti-vaccine articles in the dataset. Mixed-valence or neutral articles mixed cancer prevention discourse with ideological appeals about protecting parental rights, and were mostly produced by local news outlets. CONCLUSION The results of this study can help health communicators anticipate the types of discourses that vaccine-hesitant parents may have encountered online. Implications and suggestions for practice are discussed.
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Affiliation(s)
| | - Elaine Avshman
- Texas A&M University School of Medicine, Bryan, TX, 77807, USA
| | - Ross Shegog
- UTHealth Houston School of Public Health, Houston, TX, 77054, USA
| | - Lara S Savas
- UTHealth Houston School of Public Health, Houston, TX, 77054, USA
| | - L Aubree Shay
- UTHealth Houston School of Public Health, San Antonio, TX, 78229, USA
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2
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Rai S, Kornides M, Morgan J, Kumar A, Cappella J, Guntuku SC. Detecting and monitoring concerns against HPV vaccination on social media using large language models. Sci Rep 2024; 14:14362. [PMID: 38906941 PMCID: PMC11192875 DOI: 10.1038/s41598-024-64703-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 06/12/2024] [Indexed: 06/23/2024] Open
Abstract
Health risks due to preventable infections such as human papillomavirus (HPV) are exacerbated by persistent vaccine hesitancy. Due to limited sample sizes and the time needed to roll out, traditional methodologies like surveys and interviews offer restricted insights into quickly evolving vaccine concerns. Social media platforms can serve as fertile ground for monitoring vaccine-related conversations and detecting emerging concerns in a scalable and dynamic manner. Using state-of-the-art large language models, we propose a minimally supervised end-to-end approach to identify concerns against HPV vaccination from social media posts. We detect and characterize the concerns against HPV vaccination pre- and post-2020 to understand the evolution of HPV vaccine discourse. Upon analyzing 653 k HPV-related post-2020 tweets, adverse effects, personal anecdotes, and vaccine mandates emerged as the dominant themes. Compared to pre-2020, there is a shift towards personal anecdotes of vaccine injury with a growing call for parental consent and transparency. The proposed approach provides an end-to-end system, i.e. given a collection of tweets, a list of prevalent concerns is returned, providing critical insights for crafting targeted interventions, debunking messages, and informing public health campaigns.
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Affiliation(s)
- Sunny Rai
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Melanie Kornides
- School of Nursing, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jennifer Morgan
- School of Nursing, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Aman Kumar
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Joseph Cappella
- Annenberg School of Communication, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Sharath Chandra Guntuku
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, 19104, USA
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3
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DeMora SL, Granados Samayoa JA, Albarracín D. Social media use and vaccination among Democrats and Republicans: Informational and normative influences. Soc Sci Med 2024; 352:117031. [PMID: 38850678 DOI: 10.1016/j.socscimed.2024.117031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/15/2024] [Accepted: 05/29/2024] [Indexed: 06/10/2024]
Abstract
Our objective was to determine whether social media influences vaccination through informational and normative influences among Democrats and Republicans. We use a probability-based longitudinal study of Americans (N = 1768) collected between December 2022 and September 2023 to examine the prospective associations between social media use and vaccination as well as informational and normative influence as mediating processes. Greater social media use correlates with more frequent vaccination (cross-lagged coefficients: COVID-19 = 0.113, p < 0.001; influenza = 0.123, p < 0.001). The underlying processes, however, vary between Democrats and Republicans. Democrats who use social media more are more likely to vaccinate because they encounter information about new pathogens. In contrast, Republicans who use social media more are more likely to vaccinate because they think that people who are important to them receive the recommended vaccines. Our findings underscore the potential for social media campaigns to promote vaccination, among both Democrats and Republicans by paying attention to the specific processes in each audience.
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Affiliation(s)
- Stephanie L DeMora
- Annenberg Public Policy Center, University of Pennsylvania, 202 S 36th St, Philadelphia, PA 19104, USA.
| | - Javier A Granados Samayoa
- Annenberg Public Policy Center, University of Pennsylvania, 202 S 36th St, Philadelphia, PA 19104, USA.
| | - Dolores Albarracín
- Annenberg Public Policy Center, University of Pennsylvania, 202 S 36th St, Philadelphia, PA 19104, USA.
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4
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Luo Y, Liu T, Yang X, Lu M, Kou Z, Xu X. Human papillomavirus vaccination and contributing factors of vaccination intention among adolescents and young adults in China from a socio-ecological perspective: A cross-sectional study. Public Health Nurs 2024; 41:602-616. [PMID: 38554075 DOI: 10.1111/phn.13315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 03/06/2024] [Accepted: 03/20/2024] [Indexed: 04/01/2024]
Abstract
OBJECTIVES Adolescents and young adults are the main target population for human papillomavirus (HPV). The study aimed to investigate school students' HPV vaccination intentions and explore the contributing factors from a socio-ecological perspective. DESIGN A questionnaire survey was conducted in three secondary schools and three colleges in China. SAMPLE A total of 1756 students aged 14-22 years participated in this study. Among the 1756 participants, 182 students have received the HPV vaccine. For the remaining 1574 students, we analyzed their HPV vaccination intentions and the influencing factors. MEASUREMENTS Survey items for sociodemographics, knowledge and awareness of HPV, sexual intercourse and sexual knowledge, subjective socioeconomic status, self-efficacy, eHealth literacy, perceived social support from family, and the availability of HPV vaccine information were measured. RESULTS Only 182 (10.4%) had received the HPV vaccine among the 1756 participants. Among the remaining 1574 students, the majority of the students (1403, 89.1%) were willing to receive the HPV vaccine. Binary logistic regression analysis showed that students who were female, had lower self-efficacy, scored higher on sexual knowledge, believed vaccination preventing related diseases, worried about side effects after vaccination, thought oneself at risk of contracting HPV, had higher family support, knew the availability of the HPV vaccine in Mainland China from healthcare institutions, and with family residence in rural areas were more willing to receive the HPV vaccine. CONCLUSIONS Students had high HPV vaccination intentions while had low vaccination rate. Intrapersonal, interpersonal and institutional or community factors predicted HPV vaccination intention. Public health nurses in communities and schools could target the modifiable factors to promote students' HPV vaccine uptake.
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Affiliation(s)
- Ying Luo
- Qingdao University, School of Nursing, Qingdao, Shandong, China
| | - Ting Liu
- Qingdao University, School of Nursing, Qingdao, Shandong, China
| | - Xiuling Yang
- Qingdao University, School of Nursing, Qingdao, Shandong, China
| | - Mingqin Lu
- Qingdao University, School of Nursing, Qingdao, Shandong, China
| | - Zhiru Kou
- Qingdao University, School of Nursing, Qingdao, Shandong, China
| | - Xiaohan Xu
- Qingdao University, School of Nursing, Qingdao, Shandong, China
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5
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Buller DB, Sussman AL, Thomson CA, Kepka D, Taren D, Henry KL, Warner EL, Walkosz BJ, Woodall WG, Nuss K, Blair CK, Guest DD, Borrayo EA, Gordon JS, Hatcher J, Wetter DW, Kinsey A, Jones CF, Yung AK, Christini K, Berteletti J, Torres JA, Barraza Perez EY, Small A. #4Corners4Health Social Media Cancer Prevention Campaign for Emerging Adults: Protocol for a Randomized Stepped-Wedge Trial. JMIR Res Protoc 2024; 13:e50392. [PMID: 38386396 PMCID: PMC10921336 DOI: 10.2196/50392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Many emerging adults (EAs) are prone to making unhealthy choices, which increase their risk of premature cancer morbidity and mortality. In the era of social media, rigorous research on interventions to promote health behaviors for cancer risk reduction among EAs delivered over social media is limited. Cancer prevention information and recommendations may reach EAs more effectively over social media than in settings such as health care, schools, and workplaces, particularly for EAs residing in rural areas. OBJECTIVE This pragmatic randomized trial aims to evaluate a multirisk factor intervention using a social media campaign designed with community advisers aimed at decreasing cancer risk factors among EAs. The trial will target EAs from diverse backgrounds living in rural counties in the Four Corners states of Arizona, Colorado, New Mexico, and Utah. METHODS We will recruit a sample of EAs (n=1000) aged 18 to 26 years residing in rural counties (Rural-Urban Continuum Codes 4 to 9) in the Four Corners states from the Qualtrics' research panel and enroll them in a randomized stepped-wedge, quasi-experimental design. The inclusion criteria include English proficiency and regular social media engagement. A social media intervention will promote guideline-related goals for increased physical activity, healthy eating, and human papillomavirus vaccination and reduced nicotine product use, alcohol intake, and solar UV radiation exposure. Campaign posts will cover digital and media literacy skills, responses to misinformation, communication with family and friends, and referral to community resources. The intervention will be delivered over 12 months in Facebook private groups and will be guided by advisory groups of community stakeholders and EAs and focus groups with EAs. The EAs will complete assessments at baseline and at 12, 26, 39, 52, and 104 weeks after randomization. Assessments will measure 6 cancer risk behaviors, theoretical mediators, and participants' engagement with the social media campaign. RESULTS The trial is in its start-up phase. It is being led by a steering committee. Team members are working in 3 subcommittees to optimize community engagement, the social media intervention, and the measures to be used. The Stakeholder Organization Advisory Board and Emerging Adult Advisory Board were formed and provided initial input on the priority of cancer risk factors to target, social media use by EAs, and community resources available. A framework for the social media campaign with topics, format, and theoretical mediators has been created, along with protocols for campaign management. CONCLUSIONS Social media can be used as a platform to counter misinformation and improve reliable health information to promote health behaviors that reduce cancer risks among EAs. Because of the popularity of web-based information sources among EAs, an innovative, multirisk factor intervention using a social media campaign has the potential to reduce their cancer risk behaviors. TRIAL REGISTRATION ClinicalTrials.gov NCT05618158; https://classic.clinicaltrials.gov/ct2/show/NCT05618158. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/50392.
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Affiliation(s)
| | - Andrew L Sussman
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Deanna Kepka
- College of Nursing and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Douglas Taren
- Section of Nutrition, University of Colorado Denver, Aurora, CO, United States
| | - Kimberly L Henry
- Department of Psychology, College of Natural Sciences, Colorado State University, Fort Collins, CO, United States
| | - Echo L Warner
- College of Nursing and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | | | - Kayla Nuss
- Klein Buendel, Golden, CO, United States
| | - Cindy K Blair
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
| | - Dolores D Guest
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
| | - Evelinn A Borrayo
- University of Colorado Cancer Center, University of Colorado Denver, Aurora, CO, United States
| | - Judith S Gordon
- College of Nursing, University of Arizona, Tucson, AZ, United States
| | | | - David W Wetter
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | - Christopher F Jones
- University of Colorado Cancer Center, University of Colorado Denver, Aurora, CO, United States
| | - Angela K Yung
- College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Kaila Christini
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | | | - John A Torres
- University of New Mexico Comprehensive Cancer Care Center, Albuquerque, NM, United States
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6
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Terada M, Okuhara T, Nagasawa T, Okada H, Goto E, Kiuchi T. Public perception of the resumption of HPV vaccine recommendation in Japan: Twitter content analysis. Health Promot Int 2023; 38:daad153. [PMID: 37966160 PMCID: PMC10647016 DOI: 10.1093/heapro/daad153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023] Open
Abstract
On 12 November 2021, after a stagnation of 8.5 years, Japan decided to resume proactive recommendations for HPV vaccines. However, it is not known how the public reacted to the resumption of proactive recommendations for HPV vaccines, which are key elements in health communication that promote HPV vaccination. This study aimed to capture discussions on HPV vaccination on Twitter and to identify user characteristics, sentiments, discussed themes and their potential reach before and after 12 November 2021, when the Ministry of Health, Labour, and Welfare's decision to resume proactive recommendation for HPV vaccines was first reported by the media in Japan. This study conducted a content analysis of tweets related to HPV vaccines posted on 11 November and 12 November 2021. Tweets were coded in terms of user characteristics, sentiments (i.e. positive, negative and neutral) and themes. Reach was measured by the number of retweets, likes and followers. A total of 3623 tweets were identified. The results showed that approximately 50% of health professionals and researchers tweeted neutral content about HPV vaccines. The most frequently discussed theme was the safety and side effects of HPV vaccines, which was accompanied by mainly negative sentiments. Although health professionals and researchers are influential on Twitter, half of them tweeted neutrally about HPV vaccines. Influential professionals, such as health professionals and researchers, are expected to disseminate accurate information to correct misinformation and recommend HPV vaccination on Twitter to overcome the HPV vaccination crisis, which is characterized by the low vaccination rates.
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Affiliation(s)
- Marina Terada
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomomi Nagasawa
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroko Okada
- Department of Health Communication, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Eiko Goto
- Department of Health Communication, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Fritz C, Barrette LX, Prasad A, Triantafillou V, Suresh N, De Ravin E, Rajasekaran K. Human papillomavirus related oropharyngeal cancer: identifying and quantifying topics of patient interest. J Laryngol Otol 2023; 137:1141-1148. [PMID: 36794539 DOI: 10.1017/s0022215123000270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
OBJECTIVE As the incidence of human papillomavirus related oropharyngeal cancer continues to rise, it is increasingly important for public understanding to keep pace. This study aimed to identify areas of patient interest and concern regarding human papillomavirus and oropharyngeal cancer. METHOD This study was a retrospective survey of search queries containing the keywords 'HPV cancer' between September 2015 and March 2021. RESULTS There was 3.5-fold more interest in human papillomavirus related oropharyngeal cancer (15 800 searches per month) compared with human papillomavirus related cervical cancer (4500 searches per month). Among searches referencing cancer appearance, 96.8 per cent pertained to the head and neck region (3050 searches per month). Among vaccination searches, 16 of 47 (34.0 per cent; 600 searches per month) referenced human papillomavirus vaccines as being a cause of cancer rather than preventing cancer. CONCLUSION The vast majority of online searches into human papillomavirus cancer pertain to the oropharynx. There are relatively few search queries on the topic of vaccination preventing human papillomavirus associated oropharyngeal cancer, which highlights the continued importance of patient education and awareness campaigns.
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Affiliation(s)
- C Fritz
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - L-X Barrette
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - A Prasad
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - V Triantafillou
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - N Suresh
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - E De Ravin
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - K Rajasekaran
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
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8
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Deng D, Shen Y, Li W, Zeng N, Huang Y, Nie X. Challenges of hesitancy in human papillomavirus vaccination: Bibliometric and visual analysis. Int J Health Plann Manage 2023; 38:1161-1183. [PMID: 37309072 DOI: 10.1002/hpm.3665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/30/2023] [Accepted: 05/15/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) vaccine has immense research value in the prevention of related tumours. A huge body of work has been published in this field, which may pose difficulties for researchers aiming to investigate all the available information. However, bibliometrics can provide deep insights into this research field. OBJECTIVE We aimed to study HPV vaccine development, visually analyse the development status, trends, research hotspots, and frontiers of this field, and provide a reference for research on it. METHODS Articles were acquired from the Web of Science Core Collection. VOS viewer and CiteSpace software were used to analyse publication growth, country/region, institution, journal distribution, author, reference, and keywords, and collected burst keyword words to display research hotspots. RESULTS A total of 4831 references were obtained, and the annual number of publications increased fluctuating over the past decade. The United States of America ranked at the top in terms of percentage of articles. The institution with the highest number of research publications in this field was the Centers for Disease Control and Prevention. The most productive and frequently cited authors was Lauri E Markowitz. The journal with the most publications in this field was Vaccine, and the most influential journal was Paediatrics. The most frequently cited reference was 'A 9-Valent HPV Vaccine against Infection and Intraepithelial Neoplasia in Women'. Burst detection analysis of top keywords showed that 'national immunisation survey', 'social media', and 'hesitancy' are the current research frontiers in this field. CONCLUSION This study provides useful information for acquiring knowledge on HPV vaccine. Research on solving the hesitation of HPV vaccination will become an academic trend in this field, which can offer guidance for more extensive and in-depth studies in the future.
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Affiliation(s)
- Disi Deng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yifeng Shen
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wanjing Li
- Department of Gynaecology, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Nan Zeng
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yefang Huang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaowei Nie
- Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
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9
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Laschke A, Blaakaer J, Jensen CF, Larsen MB. Danish women's preferences regarding gynecological examination support international recommendations: A cross-sectional study. Int J Gynaecol Obstet 2023; 162:1068-1076. [PMID: 37158417 DOI: 10.1002/ijgo.14828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Gynecological examinations (GEs) are challenging for many women. Several recommendations and guidelines have emerged, partly based on common sense and clinicians' consensus. However, there is a lack of knowledge regarding women's opinions. Therefore, this study aimed to describe women's preferences and experiences in relation to GEs and investigate whether they are dependent on their socioeconomic status. METHODS In Denmark, GEs are typically performed by general practitioners or resident specialists in gynecology (RSGs) in gynecological hospital departments. This cross-sectional questionnaire and register study included approximately 3000 randomly selected patients who visited six RSGs from January 1, 2020, to March 1, 2021. The main outcome measurement involved women's preferences and experiences regarding GEs. RESULTS Overall, 37% of the women thought that a changing room was important, 20% preferred a garment to cover themselves, 18% preferred a separate examination room, and 13% thought that the presence of a chaperone was important. Compared with working and retired women, more women outside the workforce felt insufficiently informed, considered their experience with RSGs unprofessional, and found GEs painful. CONCLUSION Our results support existing recommendations regarding GEs and the related environment, confirming that privacy and modesty are factors to take into consideration as they are of concern for a relatively large group of women. Thus, providers should focus on women outside the workforce, because this group appears to feel vulnerable in this environment.
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Affiliation(s)
- Alexander Laschke
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Speciallaegeselskabet Alexander Laschke ApS, Aabenraa, Denmark
| | - Jan Blaakaer
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark
| | | | - Mette Bach Larsen
- Department of Public Health Programmes, Randers Regional Hospital, University Research Clinic for Cancer Screening, Randers, Denmark
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10
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Adjei Boakye E, Nair M, Abouelella DK, Joseph CL, Gerend MA, Subramaniam DS, Osazuwa-Peters N. Trends in Reasons for Human Papillomavirus Vaccine Hesitancy: 2010-2020. Pediatrics 2023; 151:e2022060410. [PMID: 37218460 PMCID: PMC10233736 DOI: 10.1542/peds.2022-060410] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 05/24/2023] Open
Abstract
OBJECTIVES We sought to identify trends in the main reasons United States parents of unvaccinated children gave for not intending to vaccinate their adolescent children against HPV from 2010 to 2020. As interventions designed to increase vaccine uptake have been implemented across the United States, we predicted that reasons for hesitancy have changed over this period. METHODS We analyzed data from the 2010 to 2020 National Immunization Survey-Teen, which included 119 695 adolescents aged 13 to 17 years. Joinpoint regression estimated yearly changes in the top five cited reasons for not intending to vaccinate using annual percentage changes. RESULTS The five most frequently cited reasons for not intending to vaccinate included "not necessary," "safety concerns," "lack of recommendation," "lack of knowledge," and "not sexually active." Overall, parental HPV vaccine hesitancy decreased by 5.5% annually between 2010 and 2012 and then remained stable for the 9-year period of 2012 through 2020. The proportion of parents citing "safety or side effects" as a reason for vaccine hesitancy increased significantly by 15.6% annually from 2010 to 2018. The proportion of parents citing "not recommended," "lack of knowledge," or "child not sexually active" as reasons for vaccine hesitancy decreased significantly by 6.8%, 9.9%, and 5.9% respectively per year between 2013 and 2020. No significant changes were observed for parents citing "not necessary." CONCLUSIONS Parents who cited vaccine safety as a reason for not intending to vaccinate their adolescent children against HPV increased over time. Findings support efforts to address parental safety concerns surrounding HPV vaccination.
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Affiliation(s)
- Eric Adjei Boakye
- Departments of Public Health Sciences
- Otolaryngology – Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan
| | | | - Dina K Abouelella
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
| | | | - Mary A. Gerend
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida
| | - Divya S. Subramaniam
- Department of Health and Clinical Outcomes Research
- Advanced HEAlth Data (AHEAD) Institute, Saint Louis University School of Medicine, Saint Louis, Missouri
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
- Duke Cancer Institute, Duke University, Durham, North Carolina
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11
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Boucher JC, Kim SY, Jessiman-Perreault G, Edwards J, Smith H, Frenette N, Badami A, Scott LA. HPV vaccine narratives on Twitter during the COVID-19 pandemic: a social network, thematic, and sentiment analysis. BMC Public Health 2023; 23:694. [PMID: 37060069 PMCID: PMC10102693 DOI: 10.1186/s12889-023-15615-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 04/05/2023] [Indexed: 04/16/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has increased online interactions and the spread of misinformation. Some researchers anticipate benefits stemming from improved public awareness of the value of vaccines while others worry concerns around vaccine development and public health mandates may have damaged public trust. There is a need to understand whether the COVID-19 pandemic, vaccine development, and vaccine mandates have influenced HPV vaccine attitudes and sentiments to inform health communication strategies. METHODS We collected 596,987 global English-language tweets from January 2019-May 2021 using Twitter's Academic Research Product track. We determined vaccine confident and hesitant networks discussing HPV immunization using social network analysis. Then, we used a neural network approach to natural language processing to measure narratives and sentiment pertaining to HPV immunization. RESULTS Most of the tweets in the vaccine hesitant network were negative in tone (54.9%) and focused on safety concerns surrounding the HPV vaccine while most of the tweets in the vaccine confident network were neutral (51.6%) and emphasized the health benefits of vaccination. Growth in negative sentiment among the vaccine hesitant network corresponded with legislative efforts in the State of New York to mandate HPV vaccination for public school students in 2019 and the WHO declaration of COVID-19 as a Global Health Emergency in 2020. In the vaccine confident network, the number of tweets concerning the HPV vaccine decreased during the COVID-19 pandemic but in both vaccine hesitant and confident networks, the sentiments, and themes of tweets about HPV vaccine were unchanged. CONCLUSIONS Although we did not observe a difference in narratives or sentiments surrounding the HPV vaccine during the COVID-19 pandemic, we observed a decreased focus on the HPV vaccine among vaccine confident groups. As routine vaccine catch-up programs restart, there is a need to invest in health communication online to raise awareness about the benefits and safety of the HPV vaccine.
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Affiliation(s)
- Jean-Christophe Boucher
- School of Public Policy, University of Calgary, 906 8th Avenue S.W. 5th Floor, Calgary, AB, T2P 1H9, Canada.
| | - So Youn Kim
- School of Public Policy, University of Calgary, 906 8th Avenue S.W. 5th Floor, Calgary, AB, T2P 1H9, Canada
| | - Geneviève Jessiman-Perreault
- Provincial Population and Public Health, Alberta Health Services, Holy Cross Centre, 2210 2 St SW, Calgary, AB, T2S 3C3, Canada
| | - Jack Edwards
- School of Public Policy, University of Calgary, 906 8th Avenue S.W. 5th Floor, Calgary, AB, T2P 1H9, Canada
| | - Henry Smith
- School of Public Policy, University of Calgary, 906 8th Avenue S.W. 5th Floor, Calgary, AB, T2P 1H9, Canada
| | - Nicole Frenette
- Provincial Population and Public Health, Alberta Health Services, Holy Cross Centre, 2210 2 St SW, Calgary, AB, T2S 3C3, Canada
| | - Abbas Badami
- School of Public Policy, University of Calgary, 906 8th Avenue S.W. 5th Floor, Calgary, AB, T2P 1H9, Canada
| | - Lisa Allen Scott
- Provincial Population and Public Health, Alberta Health Services, Holy Cross Centre, 2210 2 St SW, Calgary, AB, T2S 3C3, Canada
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12
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Cherven B, Klosky JL, Elizabeth Keith K, Hudson MM, Bhatia S, Landier W. Reasons for refusal of the human papillomavirus vaccine among young cancer survivors. Cancer 2023; 129:614-623. [PMID: 36530157 PMCID: PMC10283160 DOI: 10.1002/cncr.34521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/07/2022] [Accepted: 09/30/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Cancer survivors are at risk for developing subsequent human papillomavirus (HPV)-related malignancies. HPV vaccination rates among survivors remain low, and the reasons for refusal of the vaccine are unclear in this population. METHODS The authors conducted a secondary analysis of data from an open-label clinical trial evaluating the immunogenicity and safety of the HPV vaccine among vaccine-naive cancer survivors who were 9-26 years old and 1-5 years from the completion of their cancer treatment. Survivors/parents who declined trial participation were asked their reasons for declining. Refusal reasons were categorized, and multivariable logistic regression models were developed to identify associations between survivor characteristics and primary refusal reasons. RESULTS Among the 301 survivors who refused participation in the clinical trial, 215 (71.4%) refused for reasons related to the HPV vaccine. Reasons for vaccine-related refusal included safety concerns, vaccine hesitancy/disinterest, external influences, vaccine-related information deficits, and health beliefs/family decisional processes. Compared with males, females were more likely to refuse for reasons related to health beliefs/family decisional processes (odds ratio [OR], 2.08; 95% confidence interval [CI], 1.12-3.93; p = .022) and were less likely to do so because of external influences (OR, 0.43; 95% CI, 0.19-0.92; p = .035). Survivors approached about participation during the latter years of the trial were more likely to refuse because of safety concerns (OR, 3.33; 95% CI, 1.55-7.69; p = .003). CONCLUSIONS Cancer survivors refused participation in an open-label trial evaluating the immunogenicity and safety of the HPV vaccine primarily because of vaccine-related concerns that were unrelated to the research study. Many of these concerns are potentially addressable by health care providers using evidence-based messages tailored to the cancer survivor population.
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Affiliation(s)
- Brooke Cherven
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
- Aflac Cancer & Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - James L. Klosky
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
- Aflac Cancer & Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - K. Elizabeth Keith
- Institute for Cancer Outcomes and Survivorship, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Melissa M. Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Wendy Landier
- Institute for Cancer Outcomes and Survivorship, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
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13
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Xin M, Luo S, Wang S, Zhao J, Zhang G, Li L, Li L, Lau JTF. The Roles of Information Valence, Media Literacy and Perceived Information Quality on the Association Between Frequent Social Media Exposure and COVID-19 Vaccination Intention. Am J Health Promot 2023; 37:189-199. [PMID: 35972385 PMCID: PMC9382572 DOI: 10.1177/08901171221121292] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE This study aimed to examine the associations between frequent exposure to positive/negative information about vaccine efficacy/safety on social media and intention of COVID-19 vaccination, and to test if media literacy and perceived information quality would moderate such associations. DESIGN A multi-city cross-sectional survey. SETTING At five universities in different regions of China. SUBJECTS 6922 university students (a response rate of 72.3%). MEASURES frequency of exposure to social media information about COVID-19 vaccination, media literacy, perceived information quality, intention of COVID-19 vaccination, and sociodemographic characteristics. ANALYSIS Logistic regression analysis was conducted to test main and interaction effects. RESULTS Higher exposure to positive information about vaccine efficacy (adjusted odds ratio [AOR] = 1.30, P < .001) and vaccine safety (AOR = 1.27, P < .001) were positively associated with vaccination intention. No significant associations were shown between exposure to negative information about vaccine efficacy/safety and vaccination intention. Higher net exposure to negative vs positive information was negatively associated with vaccination intention (AOR = .82, P < .001). High media literacy was further found to attenuate the effect of negative information exposure and strengthen that of positive information exposure. Perceived information quality was not a significant moderator. CONCLUSION The valence of social media information regarding the efficacy and safety of COVID-19 vaccines and individuals' media literacy jointly shaped COVID-19 vaccination intention. The findings can inform the development of effective health promotion strategies for enhancing COVID-19 vaccination.
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Affiliation(s)
- Meiqi Xin
- Department of Rehabilitation
Sciences, The Hong Kong Polytechnic
University, Hong Kong SAR, China
| | - Sitong Luo
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Suhua Wang
- Graduate School of Baotou Medical
College, Baotou Medical College, Baotou, China
| | - Junfeng Zhao
- Department of Psychology, School of
Education, Henan University, Kaifeng, China
| | - Guohua Zhang
- Department of Psychology, School of
Psychiatry, Wenzhou Medical
University, Wenzhou, China
| | - Lijuan Li
- School of Public Health, Dali University, Dali, China
| | - Liping Li
- Shantou University Medical
College, Shantou, China
| | - Joseph Tak-Fai Lau
- School of Mental Health, Wenzhou Medical
University, Wenzhou, China
- Affiliated Kangning Hospital of
Wenzhou Medical University, Wenzhou, China
- School of Public Health, Zhejiang University, Hangzhou, China
- Centre for Health Behaviours
Research, The Chinese University of Hong
Kong, Hong Kong SAR, China
- Joseph Tak-Fai Lau, Jockey Club School of
Public Health and Primary Care, The Chinese University of Hong Kong, Room 505,
5/F, Prince of Wales Hospital, New Territory, Hong Kong, China.
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14
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Zhang L, Yang J, Cao Y, Kang W. Sociocultural-psychological predictors influencing parents' decision-making regarding HPV vaccination for their adolescent daughters in mainland China: An extended TPB model. Front Public Health 2023; 10:1035658. [PMID: 36684984 PMCID: PMC9853056 DOI: 10.3389/fpubh.2022.1035658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/12/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction Enhancing human papillomavirus (HPV) vaccine uptake rates to protect women's health is an important public health issue worldwide. China has taken a series of measures in recent years to promote HPV vaccination among school-aged girls, but the vaccine uptake rate remains low. Investigating the factors influencing vaccination-related decision-making of adolescent girls' parents is key to solving the problem. This study aimed to examine the influence of sociocultural-psychological predictors, including exposure to HPV-related stories (positive/negative), affective reactions (pride/regret), injunctive norms on the Internet and perceived moral obligation, on parents' HPV vaccination-related decision-making for girls aged 13-15 years in mainland China. Methods A cross-sectional online survey using quota sampling was conducted in February 2022. Four hundred and five valid and qualified questionnaires were obtained. Partial least squares structural equation modeling was performed by SmartPLS 3 (i) to evaluate the reliability and validity of the measurement models of 11 constructs, and (ii) to test the effect relationships of the sociocultural-psychological predictors on parents' intention to vaccinate their daughters. Results The study findings showed that parental decision-making regarding HPV vaccination was influenced by sociocultural and psychological factors. At the level of individual psychological factors, exposure to positive stories was significantly associated with perceived vaccine effectiveness (β = 0.331, t = 8.448, p < 0.001), which strongly predicted the attitude toward vaccination (β = 0.521, t = 8.133, p < 0.001); anticipated pride had more positive influence on vaccination-related decision-making (β = 0.156, t = 2.176, p < 0.05) than anticipated regret. In terms of social influence, injunctive norms on the Internet had a significantly positive influence on vaccination intention (β = 0.127, t = 2.382, p < 0.05), similar to descriptive norms (β = 0.135, t = 3.358, p < 0.01). Perceived moral obligation at the cultural level was the strongest predictor of parental decision-making regarding HPV vaccination (β = 0.193, t = 2.139, p < 0.05). Discussion This study is the first in mainland China to systematically examine the sociocultural-psychological predictors of parents' decision-making to vaccinate their 13-15-year-old daughters against HPV. A new extended TPB model with a sociocultural-psychological approach was developed. This model can support the investigation of factors affecting HPV vaccine uptake rates in the mainland Chinese population and similar populations and help to understand the differences in vaccination-related decision-making between Eastern and Western cultures. Furthermore, the study provided some suggestions for HPV vaccination communication campaigns targeting adolescent girls' parents.
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Affiliation(s)
- Lingmin Zhang
- School of Journalism and Communication, Guangzhou University, Guangzhou, China
| | - Jian Yang
- School of Journalism and Communication, Guangzhou University, Guangzhou, China,*Correspondence: Jian Yang ✉
| | - Ye Cao
- Archives Office, Guizhou Open University, Guiyang, China
| | - Wanying Kang
- School of Media and Communication, Shenzhen University, Shenzhen, China
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15
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Osuagwu UL, Mashige KP, Ovenseri-Ogbomo G, Envuladu EA, Abu EK, Miner CA, Timothy CG, Ekpenyong BN, Langsi R, Amiebenomo OM, Oloruntoba R, Goson PC, Charwe DD, Ishaya T, Agho KE. The impact of information sources on COVID-19 vaccine hesitancy and resistance in sub-Saharan Africa. BMC Public Health 2023; 23:38. [PMID: 36609264 PMCID: PMC9816548 DOI: 10.1186/s12889-022-14972-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 12/29/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Vaccination remains the most powerful weapon against the emergence of new variants of coronavirus (COVID-19). However, false information about COVID-19 vaccines through various platforms including social media remains a major threat to global public health. This study examined the impact of information sources on COVID-19 vaccine hesitancy and resistance in sub-Saharan Africa (SSA). METHODS A validated web-based cross-sectional study was conducted from 14 March to 16 May 2021, and was administered in both French and English to 2572 participants aged 18 years and over. Data on sociodemographic characteristics, medical and vaccination history, and the information sources (mainstream media and social media) used by the participants during the pandemic were obtained. There were three main outcomes: The vaccinated group were those who responded in the affirmation (Yes) to the question of whether they have been vaccinated against COVID-19. Those who responded 'not sure' or 'no' to the question were then asked if they were willing to be vaccinated when the vaccine became available in their home countries. The responses to this follow-up question were used to derive the second and third outcome variables of 'vaccine hesitancy' and 'vaccine resistance', respectively. A series of logistic regression analyses were used to examine the impact of information sources on the three main outcomes. RESULTS The prevalence of COVID-19 vaccine hesitancy among the participants was lowest among newspaper readers (42%) and highest among TV (72%) and social media users (73%). The prevalence of COVID-19 vaccine-resistance was also lowest among newspaper readers (37%) but highest among social media users (87%). Multivariate analyses revealed that compared to those who did not use these information sources, SSA participants who relied on the radio (aOR 0.83, 95%CI = 0.70, 0.99), TV (aOR 0.80, 95%CI = 0.65, 0.97) and social media (aOR 0.79, 95%CI = 0.65, 0.97) for information during the pandemic were less likely to be hesitant towards taking the vaccines. However, social media users (aOR 2.13, 95%CI = 1.62, 2.80), those who watched TV (aOR 1.40, 95%CI =1.08, 1.80), relied on healthcare workers (HCWs: aOR 1.32, 95%CI = 1.07, 1.63) and families/friends (aOR 1.31, 95%CI = 1.06, 1.61) for COVID-19 related information during the pandemic were more likely to resist taking the COVID vaccines in this study. Participants who relied on the newspaper for information during the pandemic were less likely to resist the vaccines (aOR 0.77, 95%CI = 0.62, 0.95) compared to non-readers of a newspaper. CONCLUSION We found that all six information sources except radio were strong predictors of the resistance towards COVID-19 vaccination. Further research on how these channels can be used to improve the availability of reliable healthcare information is needed. Investments in these resources will protect people and empower them to make appropriate choices about their health.
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Affiliation(s)
- Uchechukwu L. Osuagwu
- grid.1029.a0000 0000 9939 5719Bathurst Rural Clinical School (BRCS), School of Medicine, Western Sydney University Bathurst, Bathurst, NSW 2795 Australia ,grid.16463.360000 0001 0723 4123African Vision Research Institute, Discipline of Optometry, Westville Campus, University of KwaZulu-Natal, Durban, 3629 South Africa ,grid.1029.a0000 0000 9939 5719Translational Health Research Institute (THRI), Western Sydney University, Campbeltown, NSW 2560 Australia
| | - Khathutshelo P. Mashige
- grid.16463.360000 0001 0723 4123African Vision Research Institute, Discipline of Optometry, Westville Campus, University of KwaZulu-Natal, Durban, 3629 South Africa
| | - Godwin Ovenseri-Ogbomo
- grid.23378.3d0000 0001 2189 1357Department of Optometry, University of the Highlands and Islands, Inverness, IV2 3JH UK
| | - Esther Awazzi Envuladu
- grid.412989.f0000 0000 8510 4538Department of Community Medicine, College of Health Sciences, University of Jos, Jos, 930003 Nigeria
| | - Emmanuel Kwasi Abu
- grid.413081.f0000 0001 2322 8567Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, 00233 Ghana
| | - Chundung Asabe Miner
- grid.412989.f0000 0000 8510 4538Department of Community Medicine, College of Health Sciences, University of Jos, Jos, 930003 Nigeria
| | - Chikasirimobi G. Timothy
- grid.442592.c0000 0001 0746 093XDepartment of Optometry, Faculty of Health sciences, Mzuzu University, P. Bag 201 Luwinga 2,, Mzuzu, Malawi
| | - Bernadine N. Ekpenyong
- grid.16463.360000 0001 0723 4123African Vision Research Institute, Discipline of Optometry, Westville Campus, University of KwaZulu-Natal, Durban, 3629 South Africa ,grid.413097.80000 0001 0291 6387Department of Public Health, Faculty of Allied Medical Sciences, College of Medical Sciences, University of Calabar, Cross River State, Calabar, 540271 Nigeria
| | - Raymond Langsi
- grid.449799.e0000 0004 4684 0857Health Division, University of Bamenda, Bambili, P. O. Box 39, Cameroon
| | - Onyekachukwu M. Amiebenomo
- grid.413068.80000 0001 2218 219XDepartment of Optometry, Faculty of Life Sciences, University of Benin, Benin, Nigeria ,School of Optometry and Vision Sciences, College of Biomedical Sciences, Cardiff, CF24 4HQ UK
| | - Richard Oloruntoba
- grid.1032.00000 0004 0375 4078School of Management and Marketing, Curtin Business School, Curtin University, Bentley, WA 6151 Australia
| | - Piwuna Christopher Goson
- grid.412989.f0000 0000 8510 4538Department of Psychiatry, College of Health Sciences, University of Jos, Jos, Nigeria
| | - Deborah Donald Charwe
- grid.419861.30000 0001 2217 1343Tanzania Food and Nutrition Center, P. O. Box 977, Dar es Salaam, Tanzania
| | - Tanko Ishaya
- grid.412989.f0000 0000 8510 4538Department of Computer Science, University of Jos, Jos, 930003 Nigeria
| | - Kingsley E. Agho
- grid.16463.360000 0001 0723 4123African Vision Research Institute, Discipline of Optometry, Westville Campus, University of KwaZulu-Natal, Durban, 3629 South Africa ,grid.1029.a0000 0000 9939 5719Translational Health Research Institute (THRI), Western Sydney University, Campbeltown, NSW 2560 Australia ,grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Campbelltown, NSW 2560 Australia
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16
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A Descriptive Analysis of the Relationship between Social Media Use and Vaccine Hesitancy among a Sample of Unvaccinated Adults in Canada. Vaccines (Basel) 2022; 10:vaccines10122096. [PMID: 36560506 PMCID: PMC9785008 DOI: 10.3390/vaccines10122096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Both traditional and social media information sources have disseminated information on the COVID-19 pandemic. The content shared may influence public opinion on different mitigation strategies, including vaccination. Misinformation can alter risk perception and increase vaccine hesitancy. This study aimed to explore the impact of using social media as the primary information source about the COVID-19 vaccine on COVID-19 vaccine hesitancy among people living in Canada. Secondary objectives identified other predictors of vaccine hesitancy and distinguished the effects of using traditional and social media sources. We used quota sampling of adults in Canada [N = 985] to conduct an online survey on the Pollfish survey platform between 21st and 28th May 2021. We then used bivariate chi-squared tests and multivariable logistic regression modeling to explore the associations between using social media as one's primary source of information about the COVID-19 vaccine and vaccine hesitancy. We further analyzed the association between specific types of channels of information and vaccine hesitancy. After controlling for covariates such as age, sex, race, and ethnicity, individuals reporting social media as their primary source of COVID-19 vaccine information versus those who had not used social media as their primary source of COVID-19 vaccine information had 50% higher odds of vaccine hesitancy. Among different channels of information, we found that information from television was associated with a 40% lower odds ratio for vaccine hesitancy. Since social media platforms play an essential role in influencing hesitancy in taking the COVID-19 vaccination, it is necessary to improve the quality of social media information sources and raise people's trust in information. Meanwhile, traditional media channels, such as television, are still crucial for promoting vaccination programs.
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Kim SJ, Schiffelbein JE, Imset I, Olson AL. Countering Antivax Misinformation via Social Media: Message-Testing Randomized Experiment for Human Papillomavirus Vaccination Uptake. J Med Internet Res 2022; 24:e37559. [PMID: 36422887 PMCID: PMC9732752 DOI: 10.2196/37559] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 10/02/2022] [Accepted: 10/19/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Suboptimal adolescent human papillomavirus (HPV) vaccination rates have been attributed to parental perceptions of the HPV vaccine. The internet has been cited as a setting where misinformation and controversy about HPV vaccination have been amplified. OBJECTIVE We aimed to test message effectiveness in changing parents' attitudes and behavioral intentions toward HPV vaccination. METHODS We conducted a web-based message-testing experiment with 6 control messages and 25 experimental messages and 5 from each of the 5 salient themes about HPV vaccination (theme 1: safety, side effects, risk, and ingredient concerns and long-term or major adverse events; theme 2: distrust of the health care system; theme 3: HPV vaccine effectiveness concerns; theme 4: connection to sexual activity; and theme 5: misinformation about HPV or HPV vaccine). Themes were identified from previous web-based focus group research with parents, and specific messages were developed by the study team using content from credible scientific sources. Through an iterative process of message development, the messages were crafted to be appropriate for presentation on a social media platform. Among the 1713 participants recruited via social media and crowdsourcing sites, 1043 eligible parents completed a pretest survey questionnaire. Participants were then randomly assigned to 1 of the 31 messages and asked to complete a posttest survey questionnaire that assessed attitudes toward the vaccine and perceived effectiveness of the viewed message. A subgroup of participants (189/995, 19%) with unvaccinated children aged 9 to 14 years was also assessed for their behavioral intention to vaccinate their children against HPV. RESULTS Parents in the experimental group had increased positive attitudes toward HPV vaccination compared with those in the control group (t969=3.03, P=.003), which was associated with increased intention to vaccinate among parents of unvaccinated children aged 9 to 14 years (r=1.14, P=.05). At the thematic level, we identified 4 themes (themes 2-5) that were relatively effective in increasing behavioral intentions by positively influencing attitudes toward the HPV vaccine (χ25=5.97, P=.31, root mean square error of approximation [RMSEA]=0.014, comparative fit index [CFI]=0.91, standardized root mean square residual [SRMR]=0.031). On the message level, messages that provided scientific evidence from government-related sources (eg, the Centers for Disease Control and Prevention) and corrected misinformation (eg, "vaccines like the HPV vaccine are simply a way for pharmaceutical companies to make money. That isn't true") were effective in forming positive perceptions toward the HPV vaccination messages. CONCLUSIONS Evidence-based messages directly countering misinformation and promoting HPV vaccination in social media environments can positively influence parents' attitudes and behavioral intentions to vaccinate their children against HPV.
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Affiliation(s)
- Sunny Jung Kim
- Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, United States
| | - Jenna E Schiffelbein
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Inger Imset
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Ardis L Olson
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
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18
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Zhao Q, Yin H, Guo D. Digital Media Exposure and Health Beliefs Influencing Influenza Vaccination Intentions: An Empirical Research in China. Vaccines (Basel) 2022; 10:1913. [PMID: 36423009 PMCID: PMC9695165 DOI: 10.3390/vaccines10111913] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/03/2022] [Accepted: 11/10/2022] [Indexed: 07/24/2023] Open
Abstract
The purpose of this study was to investigate whether/how digital media exposure influences people's intention to influenza vaccination. Through an anonymous online survey, we collected data on Chinese people's exposure to influenza and influenza vaccine information on digital media platforms and their attitudes toward influenza vaccines (N = 600). The structural equation model analysis results strongly support to the research hypotheses and the proposed model. The findings reveal three major themes: (1) digital media exposure significantly influence the susceptibility and severity of influenza. (2) After exposure to digital media, it is helpful to understand the vaccine's benefits, reduce the barriers to vaccination, and finally improve the intention to vaccination. (3) Users receive cues to action from digital media, and their vaccination intention tends to be positive. These findings explore how digital media exposure influences influenza vaccination intention and may provide insights into vaccine promotion efforts in countries. Research has shown that digital media exposure contributes to getting vaccinated against influenza.
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Affiliation(s)
- Qingting Zhao
- School of Journalism and Communication, Shandong University, Jinan 250100, China
| | - Hao Yin
- School of Journalism and Communication, Nanjing Normal University, Nanjing 210097, China
| | - Difan Guo
- School of Journalism and Communication, Beijing Normal University, Beijing 100091, China
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Ferreira GRON, Formigosa JADS, Lira ALBDC, Reis RK, Gir E, Freitas WLS, Carvalho JN, Gonçalves LHT, Botelho EP, Ramos AMPC. The Family Health Strategy Influence on the Human Papillomavirus Vaccine Acceptance in a Peripheral Community of the Brazilian Amazon Region. Health Equity 2022; 6:852-861. [DOI: 10.1089/heq.2022.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | | | - Renata Karina Reis
- Graduate Program in Fundamental Nursing, Ribeirão Preto, Sao Paulo, Brazil
| | - Elucir Gir
- Graduate Program in Fundamental Nursing, Ribeirão Preto, Sao Paulo, Brazil
| | | | - Jacira Nunes Carvalho
- Graduate Nursing Program at the Federal University of Pará (UFPA), Belém, Pará, Brazil
| | | | - Eliã Pinheiro Botelho
- Graduate Nursing Program at the Federal University of Pará (UFPA), Belém, Pará, Brazil
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20
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Birnholtz J, Kraus A, Schnuer S, Tran L, Macapagal K, Moskowitz DA. 'Oh, I don't really want to bother with that:' gay and bisexual young men's perceptions of barriers to PrEP information and uptake. CULTURE, HEALTH & SEXUALITY 2022; 24:1548-1562. [PMID: 34524938 PMCID: PMC8920939 DOI: 10.1080/13691058.2021.1975825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/30/2021] [Indexed: 06/13/2023]
Abstract
Pre-exposure prophylaxis (PrEP), a daily oral pill for HIV prevention demonstrated to be effective for adults, was recently approved by the US Food and Drug Administration for use with young people weighing at least 35 kilograms. Given that young people aged 13-19 years account for a disproportionate share of new US HIV infections, PrEP presents an important opportunity. There has been limited effort, however, to increase PrEP awareness and uptake among young people. While prior work has identified barriers young people face in getting PrEP, effective strategies for overcoming these barriers have not yet been identified. This paper presents results from interviews with 15-19 year old gay and bisexual young men about their knowledge and perceptions of PrEP, and the barriers they perceive. Results suggest that participants were aware of PrEP but confused by the details of insurance coverage and out-of-pocket costs. Participants also felt parents and providers would not be knowledgeable or supportive, and were reluctant to share their own use of PrEP on social media. Suggested next steps include online parent and provider education, systemic health care reform to streamline and simplify access to preventative care and awareness campaigns that meet youth where they are on popular platforms.
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Affiliation(s)
- Jeremy Birnholtz
- Department of Communication Studies, Northwestern University, Evanston, IL, USA
| | - Ashley Kraus
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Samantha Schnuer
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Lauren Tran
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Kathryn Macapagal
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - David A. Moskowitz
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
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21
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Bhagavathula AS, Massey PM. Google Trends on Human Papillomavirus Vaccine Searches in the United States From 2010 to 2021: Infodemiology Study. JMIR Public Health Surveill 2022; 8:e37656. [PMID: 36036972 PMCID: PMC9468915 DOI: 10.2196/37656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/20/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background The human papillomavirus (HPV) vaccine is recommended for adolescents and young adults to prevent HPV-related cancers and genital warts. However, HPV vaccine uptake among the target age groups is suboptimal. Objective The aim of this infodemiology study was to examine public online searches in the United States related to the HPV vaccine from January 2010 to December 2021. Methods Google Trends (GT) was used to explore online searches related to the HPV vaccine from January 1, 2010, to December 31, 2021. Online searches and queries on the HPV vaccine were investigated using relative search volumes (RSVs). Analysis of variance was performed to investigate quarterly differences in HPV vaccine searches in each year from 2010 to 2021. A joinpoint regression was used to identify statistically significant changes over time; the α level was set to .05. Results The year-wise online search volume related to the HPV vaccine increased from 2010 to 2021, often following federal changes related to vaccine administration. Joinpoint regression analysis showed that HPV vaccine searches significantly increased on average by 8.6% (95% CI 5.9%-11.4%) across each year from 2010 to 2021. Moreover, HPV vaccine searches demonstrated a similar pattern across years, with search interest increasing through August nearly every year. At the state level, the highest 12-year mean RSV was observed in California (59.9, SD 14.3) and the lowest was observed in Wyoming (17.4, SD 8.5) during the period of 2010-2021. Conclusions Online searches related to the HPV vaccine increased by an average of 8.6% across each year from 2010 to 2021, with noticeable spikes corresponding to key changes in vaccine recommendations. We identified patterns across years and differences at the state level in the online search interest related to the HPV vaccine. Public health organizations can use GT as a tool to characterize the public interest in and promote the HPV vaccine in the United States.
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Affiliation(s)
- Akshaya Srikanth Bhagavathula
- Center for Public Health and Technology, Department of Health, Human Performance, and Recreation, College of Education and Health Professions, University of Arkansas, Fayetteville, AR, United States
| | - Philip M Massey
- Center for Public Health and Technology, Department of Health, Human Performance, and Recreation, College of Education and Health Professions, University of Arkansas, Fayetteville, AR, United States
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22
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Exploring content of misinformation about HPV vaccine on twitter. J Behav Med 2022; 46:239-252. [PMID: 35896853 PMCID: PMC9328646 DOI: 10.1007/s10865-022-00342-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 06/23/2022] [Indexed: 12/02/2022]
Abstract
Although social media can be a source of guidance about HPV vaccination for parents, the information may not always be complete or accurate. We conducted a retrospective content analysis to identify content and frequencies of occurrence of disinformation and misinformation about HPV vaccine posted on Twitter between December 15, 2019, through March 31, 2020, among 3876 unique, English language #HPV Tweets, excluding retweets. We found that 24% of Tweets contained disinformation or misinformation, and the remaining 76% contained support/education. The most prevalent categories of disinformation/misinformation were (1) adverse health effects (59%), (2) mandatory vaccination (19%), and (3) inefficacy of the vaccine (14%). Among the adverse health effects Tweets, non-specific harm/injury (51%) and death (23%) were most frequent. Disinformation/misinformation Tweets vs. supportive Tweets had 5.44 (95% CI 5.33–5.56) times the incidence rate of retweet. In conclusion, almost one-quarter of #HPV Tweets contained disinformation or misinformation about the HPV vaccine and these tweets received higher audience engagement including likes and retweets. Implications for vaccine hesitancy are discussed.
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23
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Niu Z, Qin Z, Hu P, Wang T. Health Beliefs, Trust in Media Sources, Health Literacy, and Preventive Behaviors among High-Risk Chinese for COVID-19. HEALTH COMMUNICATION 2022; 37:1004-1012. [PMID: 33557620 DOI: 10.1080/10410236.2021.1880684] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The coronavirus disease (COVID-19) broke out in China in January 2020 and has been effectively controlled in April 2020 after China's relentless efforts. People's engagement in disease-related preventive behaviors is crucial in containing such infectious disease. Vulnerable populations often have higher chances of developing severe illness from COVID-19 and the mortality rate is also higher. Thus, at-risk populations for COVID-19 request extra attention. The current study conducted a national online survey among vulnerable populations in China in early February 2020 to examine their engagement in coronavirus-related preventive health behaviors (e.g., frequent handwashing) and the potential determinants including factors from the Health Belief Model, trust in different media sources, and health literacy. The results suggested that the vulnerable populations' engagement in coronavirus-related preventive behaviors were significantly associated with barriers, benefits, self-efficacy, trust in doctors' social media, and trust in TV for COVID-19-related information. Besides, barriers, benefits, self-efficacy, trust in doctors' social media, and trust in TV mediated the effects of health literacy on preventive behaviors. Our findings provided directions for future health promotions and interventions targeting vulnerable populations to enhance their preventive behaviors in China.
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Affiliation(s)
- Zhaomeng Niu
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey
| | - Zhou Qin
- School of Arts and Sciences, Rutgers, The State University of New Jersey
| | | | - Tingting Wang
- Lingnan (University) College, Sun Yat-Sen University
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24
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Scaling up the discovery of hesitancy profiles by identifying the framing of beliefs towards vaccine confidence in Twitter discourse. J Behav Med 2022; 46:253-275. [PMID: 35635593 PMCID: PMC9148945 DOI: 10.1007/s10865-022-00328-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 04/29/2022] [Indexed: 11/02/2022]
Abstract
Our study focused on the discovery of how vaccine hesitancy is framed in Twitter discourse, allowing us to recognize at-scale all tweets that evoke any of the hesitancy framings as well as the stance of the tweet authors towards the frame. By categorizing the hesitancy framings that propagate misinformation, address issues of trust in vaccines, or highlight moral issues or civil rights, we were able to empirically recognize their ontological commitments. Ontological commitments of vaccine hesitancy framings couples with the stance of tweet authors allowed us to identify hesitancy profiles for two most controversial yet effective and underutilized vaccines for which there remains substantial reluctance among the public: the Human Papillomavirus and the COVID-19 vaccines. The discovered hesitancy profiles inform public health messaging approaches to effectively reach Twitter users with promise to shift or bolster vaccine attitudes.
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25
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Li D, Fu L, Yang Y, An R. Social media-assisted interventions on human papillomavirus and vaccination-related knowledge, intention and behavior: a scoping review. HEALTH EDUCATION RESEARCH 2022; 37:104-132. [PMID: 35305019 DOI: 10.1093/her/cyac007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
Social media holds the potential to engage adolescents and young adults and to facilitate interventions improving Human Papillomavirus Vaccine (HPVV). This article systematically reviewed the literature on Cochrane Library, PubMed, Web of Science, EMBASE, Scopus and CINAHL. Interventions delivered or facilitated by social media with outcomes of HPV-related knowledge, awareness, attitude, vaccination intention and behavior were included. Standardized forms were used to abstract the basic characteristics, settings, guiding theories and key findings of the interventions. Twenty-four studies met the eligibility criteria. Sixteen were educational interventions, and the other eight investigated the effect of social media message contents on improving Human Papillomavirus (HPV)-related outcomes. The studies were published between 2015 and 2021. The most frequently used social media platforms were Facebook, and the most commonly adopted theory was the health belief model (HBM). Existing interventions have shown preliminary but promising effects in improving HPV awareness and knowledge. Still, such improvements have not always been translated to improved behavioral intentions and vaccination rates. The contents and phrasing of social media messages and pre-existing individual characteristics of social media users moderated intervention effectiveness. Social media could be a valuable tool for engaging participants and delivering HPV interventions. Future interventions should apply stronger theory bases.
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Affiliation(s)
- Danyi Li
- Brown School, Washington University, 1 Brookings Dr, St. Louis, MO 63130, USA
| | - Linyun Fu
- Crown Family School of Social Work, Policy and Practice, The University of Chicago, 969 E. 60th Street, Chicago, IL 60637, USA
| | - Yuanyuan Yang
- Brown School, Washington University, 1 Brookings Dr, St. Louis, MO 63130, USA
| | - Ruopeng An
- Brown School, Washington University, 1 Brookings Dr, St. Louis, MO 63130, USA
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26
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Llavona-Ortiz JY, Spanos KE, Kraschnewski JL, D’Souza G, Myrick JG, Sznajder KK, Calo WA. Associations Between Human Papillomavirus Vaccine Decisions and Exposure to Vaccine Information in Social Media. Cancer Control 2022; 29:10732748221138404. [PMID: 36394959 PMCID: PMC9679613 DOI: 10.1177/10732748221138404] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023] Open
Abstract
PURPOSE Exposure to different types of vaccine information in social media can result in parents making disparate vaccine decisions, including not following national guidelines for human papillomavirus (HPV) vaccination. We sought to characterize parents' exposure to and engagement with information about HPV vaccination in social media, and the associations between exposure to such information and vaccine decisions for their adolescent children. METHODS In 2019, we conducted a web-based survey with a national sample of 1073 parents of adolescents who use social media. The survey assessed whether parents have seen information in favor, against, or mixed about HPV vaccination. Multivariable logistic regressions assessed correlates of vaccine decisions, including HPV vaccine initiation, delay, and refusal. RESULTS Sixty-one percent of parents reported that their children have initiated HPV vaccination. Over one-third of parents (37%) reported seeing HPV vaccine information on social media, which was either in favor (20%), against (5%), or a mix (12%). Parents exposed to information in favor were more likely than those who saw no information to have initiated HPV vaccination (OR = 1.74, 95% CI:1.24, 2.44). Parents exposed to information against vaccination were more likely to have delayed (OR = 3.29, 95% CI:1.66, 6.51) or refused (OR = 4.72, 95% CI:2.35, 9.50) HPV vaccination. Exposure to mixed information was also significantly associated with vaccine delay and refusal. DISCUSSION Our findings suggest that the type of information seen on social media regarding HPV vaccination may influence the decisions parents make about vaccinating their children. Efforts should be sought to increase online information in favor of HPV vaccination and combat vaccine misinformation in social media.
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Affiliation(s)
| | | | - Jennifer L. Kraschnewski
- Department of Public Health
Sciences, Penn State College of
Medicine, Hershey, PA, USA
- Department of Medicine, Penn State College of
Medicine, Hershey, PA, USA
| | - Gail D’Souza
- Department of Public Health
Sciences, Penn State College of
Medicine, Hershey, PA, USA
| | - Jessica Gall Myrick
- Donald P. Bellisario College of
Communications, Pennsylvania State
University, University Park, PA, USA
| | - Kristin K. Sznajder
- Department of Public Health
Sciences, Penn State College of
Medicine, Hershey, PA, USA
| | - William A. Calo
- Department of Public Health
Sciences, Penn State College of
Medicine, Hershey, PA, USA
- Penn State Cancer
Institute, Hershey, PA, USA
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27
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DiRusso C, Stansberry K. Unvaxxed: A Cultural Study of the Online Anti-Vaccination Movement. QUALITATIVE HEALTH RESEARCH 2022; 32:317-329. [PMID: 34847821 DOI: 10.1177/10497323211056050] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In this study, the constructive communication process of anti-vaccination advocates is explored to provide insight into the challenges of communicating with an engaged, educated public that is distrustful of mainstream medical and governmental organizations. Using the circuit of culture as a theoretical and methodological model, this article examines how anti-vaccination advocates use social media to construct and reinforce a belief system that counters dominate understandings of health. Findings show that, through online communication, anti-vaccination advocates create shared cultural constructs embracing the identity of health information crusader, critic, and expert. This community consumes, produces, and distributes information that reframes mainstream health information and reinforces shared values. The purposes of this study are to better understand the culture of anti-vaccination advocates, identify communication barriers, and offer practical implications for health care professionals.
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Affiliation(s)
- Carlina DiRusso
- Communication Department, 3930Hope College, Holland, MI, USA
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28
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Boender TS, Louis-Ferdinand N, Duschek G. Digital visual communication for public health: a design proposal for a vaccinated emoji (Preprint). J Med Internet Res 2021; 24:e35786. [PMID: 35389363 PMCID: PMC8993141 DOI: 10.2196/35786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/11/2022] [Accepted: 03/06/2022] [Indexed: 01/22/2023] Open
Abstract
In the 21st century, the internet and particularly social media have become essential platforms for the spread of health information (including misinformation and disinformation). One of the distinguishing features of communication on these platforms is the widespread use of emojis. Though seemingly trivial emojis are now used by many if not most public health figures and organizations alongside important health updates. Much of that information has had to do with vaccination. Vaccines are a critical public health tool but one surrounded by falsehoods, phobias, and misinformation fueling vaccine hesitancy. Part of that has to do with their lack of positive representation on social media (eg, the syringe emoji is a plain needle, which for many people is an uncomfortable image). We thus argue that vaccination deserves an entirely new emoji to communicate vaccine confidence and discuss a design proposal for a vaccinated emoji that has gained traction in the global public health community.
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Affiliation(s)
- Tamara Sonia Boender
- Surveillance Unit, Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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29
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Zimand-Sheiner D, Kol O, Frydman S, Levy S. To Be (Vaccinated) or Not to Be: The Effect of Media Exposure, Institutional Trust, and Incentives on Attitudes toward COVID-19 Vaccination. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12894. [PMID: 34948501 PMCID: PMC8702102 DOI: 10.3390/ijerph182412894] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022]
Abstract
The COVID-19 vaccine has become a strategic vehicle for reducing the spread of the pandemic. However, the uptake of the vaccine by the public is more complicated than simply making it available. Based on social learning theory, this study examines the role of communication sources and institutional trust as barriers and incentives as motivators of people's attitudes toward vaccination and actual vaccination. Data were collected via an online panel survey among Israelis aged 18-55 and then analyzed using structural equation modeling (SEM). Findings show that social media trust negatively mediates the effect of exposure to information on the vaccine on attitudes toward vaccination. However, mass media trust and institutional trust positively mediate this relationship. Incentives were effective motivators for forming positive attitudes and moderating the effect of institutional trust on attitude toward vaccination. This study facilitates a deeper understanding of health communication theory in pandemics and makes important recommendations for practitioners and policy makers.
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Affiliation(s)
| | - Ofrit Kol
- School of Communication, Ariel University, Ariel 40700, Israel;
| | - Smadar Frydman
- Doctoral School, Jaume I University, 12071 Castelló de la Plana, Spain;
| | - Shalom Levy
- Department of Economics and Business Administration, Ariel University, Ariel 40700, Israel;
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30
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Students' Views on Vaccination against COVID-19 Virus and Trust in Media Information about the Vaccine: The Case of Serbia. Vaccines (Basel) 2021; 9:vaccines9121430. [PMID: 34960176 PMCID: PMC8704984 DOI: 10.3390/vaccines9121430] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/25/2021] [Accepted: 11/26/2021] [Indexed: 01/14/2023] Open
Abstract
Mass immunization of the citizens of the Republic of Serbia began in January 2021. Information on the significance, manner, advantages and consequences of this process was intensively distributed through all communication channels, with the media playing a key role. According to the data of the official institutions for the public health of Serbia, by July 2021 the lowest percentage of vaccinated population was among those between the ages of 18 and 24—only 15% of this demographic had received the vaccine by this point. Given the low turnout of young people for vaccination, in this paper we investigated the general attitude of students in Serbia, as a special category of young people, towards the vaccine against the COVID-19 virus, as well as their attitude regarding information about vaccination in the media. Research was conducted on a sample of 345 students at the University of Novi Sad. The results of the research showed that 42% of students had not been vaccinated and did not plan to do so, 37.4% had received at least one dose of vaccine and 20.6% had not been vaccinated even though they planned to do so. Students who were vaccinated had more confidence in information provided through media channels than those who were not vaccinated. Therefore, it can be concluded that encouraging students to decide in favor of vaccination against the COVID-19 virus should come from the universities where they study as well as the media.
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31
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Parental motivations for seeking second medical opinions for their child’s HPV vaccine. Prev Med Rep 2021; 24:101550. [PMID: 34976620 PMCID: PMC8683845 DOI: 10.1016/j.pmedr.2021.101550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 08/30/2021] [Accepted: 09/04/2021] [Indexed: 11/22/2022] Open
Abstract
We sought to characterize parents who look for second medical opinions to get human papillomavirus (HPV) vaccine for their children and whether second opinions influenced acceptance of HPV vaccine. Between July and August 2019, we conducted an online survey with a national sample of 906 parents of adolescents ages 11–17. We used multivariable logistic regression to assess correlates of looking for second opinions on HPV vaccination. For those who looked for second opinions, the survey assessed their HPV vaccine information needs and whether their child ultimately received the vaccine. Overall, 15% of parents reported looking for second opinions. Parents were more likely to look for second opinions if their self-reported knowledge about HPV vaccine was the same (Odds ratio [OR] = 1.94; 95% confidence interval [CI]:1.13, 3.30) or more (OR = 3.97; 95% CI:2.35, 6.73) than their child’s provider, or if they reported seeing HPV vaccine information on social media (OR = 2.50; 95% CI:1.69, 3.69). Parents were also more likely to look for second opinions if they were male, reported low vaccine confidence, disagreed with social norms favoring HPV vaccination, or had a young child (all p < .05). Among parents who looked for second opinions, 32% wanted the most information about safety and side effects, and 40% decided not to get their child vaccinated or were still undecided. In conclusion, a considerable number of parents look for second opinions to obtain information about HPV vaccine yet many still decline vaccination. Evidence-based messaging addressing parents’ HPV vaccine information needs may avoid delayed vaccine initiation in search of second opinions.
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32
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Buller DB, Pagoto S, Henry K, Berteletti J, Walkosz BJ, Bibeau J, Baker K, Hillhouse J, Arroyo KM. Human Papillomavirus Vaccination and Social Media: Results in a Trial With Mothers of Daughters Aged 14-17. Front Digit Health 2021; 3:683034. [PMID: 34713152 PMCID: PMC8521953 DOI: 10.3389/fdgth.2021.683034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Parents acquire information about human papillomavirus (HPV) vaccines online and encounter vaccine-critical content, especially on social media, which may depress vaccine uptake. Secondary analysis in a randomized trial of a Facebook-delivered adolescent health campaign targeting mothers with posts on HPV vaccination was undertaken with the aims of (a) determining whether the pre–post-change occurred in self-reports of the mothers on HPV vaccination of their adolescent daughters; (b) describing the comments and reactions to vaccine posts; (c) exploring the relationship of campaign engagement of the mothers assessed by their comments and reactions to posts to change in the self-reports of the mothers of HPV vaccination. Materials and Methods: Mothers of daughters aged 14–17 were recruited from 34 states of the US (n = 869). A social media campaign was delivered in two Facebook private groups that differed in that 16% of posts in one were focused on indoor tanning (IT) and 16% in the other, on prescription drug misuse, assigned by randomization. In both groups, posts promoted HPV vaccination (n = 38 posts; no randomization) and vaccination for other disease (e.g., influenza, n = 49). HPV and other vaccination posts covered the need for a vaccine, the number of adolescents vaccinated, how vaccines are decreasing the infection rates, and stories of positive benefits of being vaccinated or harms from not vaccinating. Guided by social cognitive theory and diffusion of innovations theory, posts were intended to increase knowledge, perceived risk, response efficacy (i.e., a relative advantage over not vaccinated daughters), and norms for vaccination. Some vaccination posts linked to stories to capitalize on identification effects in narratives, as explained in transportation theory. All mothers received the posts on vaccination (i.e., there was no randomization). Mothers completed surveys at baseline and 12- and 18-month follow-up to assess HPV vaccine uptake by self-report measures. Reactions (such as sad, angry) and comments to each HPV-related post were counted and coded. Results: Initiation of HPV vaccination (1 dose) was reported by 63.4% of mothers at baseline, 71.3% at 12-month posttest (pre/post p < 0.001), and 73.3% at 18-month posttest (pre/post p < 0.001). Completion of HPV vaccination (two or three doses) was conveyed by 50.2% of mothers at baseline, 62.5% at 12-month posttest (pre/post p < 0.001), and 65.9% at 18-month posttest (pre/post p < 0.001). For posts on HPV vaccines, 8.1% of mothers reacted (n = 162 total), and 68.4% of posts received a reaction (63.2% like; 13.2% love, 7.9% sad). In addition, 7.6% of mothers commented (n = 122; 51 unfavorable, 68 favorable, 1 neutral), and 50.0% of these posts received a comment. There were no differences in pre–post change in vaccine status by the count of reactions or comments to HPV vaccine posts (Ps > 0.05). Baseline vaccination was associated with the valence of comments to HPV vaccine posts (7.2% of mothers whose daughters had completed the HPV series at baseline made a favorable comment but 7.6% of mothers whose daughters were unvaccinated made an unfavorable comment). Conclusion: Effective strategies are needed in social media to promote HPV vaccines and counter misinformation about and resistance to them. Mothers whose daughters complete the HPV vaccine course might be recruited as influencers on HPV vaccines, as they may be predisposed to talk favorably about the vaccine. Comments from mothers who have not been vaccinated should be monitored to ensure that they do not spread vaccine-critical misinformation. Study limitations included lack of randomization and control group, relatively small number of messages on HPV vaccines, long measurement intervals, inability to measure views of vaccination posts, reduced generalizability related to ethnicity and social media use, and use of self-reported vaccine status. Clinical Trial Registration:www.clinicaltrials.gov, identifier NCT02835807.
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Affiliation(s)
| | - Sherry Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Kimberly Henry
- Department of Psychology, Colorado State University, Fort Collins, CO, United States
| | | | | | - Jessica Bibeau
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Katie Baker
- Department of Community and Behavioral Health, East Tennessee State University, Johnson City, TN, United States
| | - Joel Hillhouse
- Department of Community and Behavioral Health, East Tennessee State University, Johnson City, TN, United States
| | - Kelsey M Arroyo
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
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Attitudes and Communication Preferences for Vaccines among Pregnant Women Receiving Care at a Safety-net Hospital. Womens Health Issues 2021; 32:67-73. [PMID: 34635378 DOI: 10.1016/j.whi.2021.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/01/2021] [Accepted: 09/15/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE We aimed to understand pregnant women's perceptions of vaccination during pregnancy and to assess their reaction to different vaccine messages. STUDY DESIGN English-speaking pregnant women aged 18 years or older who received prenatal care at a safety-net hospital participated in qualitative interviews. Interview topics included attitudes toward vaccinations in general and toward influenza and tetanus-diphtheria-pertussis vaccination in pregnancy. Participants were also queried regarding sources of vaccine information, and were asked to provide feedback on specific messages regarding maternal vaccination. RESULTS Twenty-eight pregnant women participated in interviews. Participant age ranged from 18 to 40 years old; 64% were insured through Medicaid. All participants had positive attitudes toward routine vaccinations and had received vaccinations for themselves and their children. Attitudes were less favorable for influenza vaccines than other vaccines. Participants reported receiving vaccine information from multiple sources. Stories about vaccine harms worried participants, even when they did not trust the sources of negative information. All stated that their health care providers were the most trusted source of information. Participants felt that the most important messages to encourage maternal vaccination were that maternal vaccination protects the baby after birth and maternal vaccination is safe for both mother and baby. Participants were not motivated to vaccinate by messages about the severity of maternal disease. CONCLUSIONS Maternal vaccinations are important to protect pregnant women and infants from influenza and pertussis. Focusing on messages related to vaccine safety and protection of the infant are motivating to mothers, especially when delivered by trusted health care providers.
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Li J, Zheng H, Duan X. Factors Influencing the Popularity of a Health-Related Answer on a Chinese Question-and-Answer Website: Case Study. J Med Internet Res 2021; 23:e29885. [PMID: 34581675 PMCID: PMC8512191 DOI: 10.2196/29885] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 08/02/2021] [Accepted: 08/12/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Social question-and-answer (Q&A) sites have become an important venue for individuals to obtain and share human papillomavirus (HPV) vaccine knowledge. OBJECTIVE This study aims to examine how different features of an HPV vaccine-related answer are associated with users' response behaviors on social Q&A websites. METHODS A total of 2953 answers and 270 corresponding questions regarding the HPV vaccine were collected from a leading Chinese social Q&A platform, Zhihu. Three types of key features, including content, context, and contributor, were extracted and coded. Negative binomial regression models were used to examine their impact on the vote and comment count of an HPV vaccine-related answer. RESULTS The findings showed that both content length and vividness were positively related to the response behaviors of HPV vaccine-related answers. In addition, compared with answers under the question theme benefits and risks, answers under the question theme vaccination experience received fewer votes and answers under the theme news opinions received more votes but fewer comments. The effects of characteristics of contributors were also supported, suggesting that answers from a male contributor with more followers and no professional identity would attract more votes and comments from community members. The significant interaction effect between content and context features further showed that long and vivid answers about HPV vaccination experience were more likely to receive votes and comments of users than those about benefits and risks. CONCLUSIONS The study provides a complete picture of the underlying mechanism behind response behaviors of users toward HPV vaccine-related answers on social Q&A websites. The results help health community organizers develop better strategies for building and maintaining a vibrant web-based community for communicating HPV vaccine knowledge.
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Affiliation(s)
- Jinhui Li
- School of Journalism and Communication, Jinan University, Guangzhou, China.,National Media Experimental Teaching Demonstration Center, Jinan University, Guangzhou, China
| | - Han Zheng
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
| | - Xu Duan
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
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Sonawane K, Lin YY, Damgacioglu H, Zhu Y, Fernandez ME, Montealegre JR, Cazaban CG, Li R, Lairson DR, Lin Y, Giuliano AR, Deshmukh AA. Trends in Human Papillomavirus Vaccine Safety Concerns and Adverse Event Reporting in the United States. JAMA Netw Open 2021; 4:e2124502. [PMID: 34533574 PMCID: PMC8449282 DOI: 10.1001/jamanetworkopen.2021.24502] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE In the US, safety concern has been identified as a primary barrier to initiating the human papillomavirus (HPV) vaccine. It is unclear if the public's sentiment concerning HPV vaccine safety aligns with postmarketing vaccine safety surveillance data. OBJECTIVE To perform a parallel assessment of trends in HPV vaccine safety concerns and HPV vaccine adverse event (AE) reporting. DESIGN, SETTING, AND PARTICIPANTS This study was a cross-sectional analysis of the National Immunization Survey (NIS) and Vaccine Adverse Event Reporting System (VAERS). Participants in the NIS were adolescents aged 13 to 17 years. AEs were reported to VAERS by patients, health care clinicians, or other sources. Statistical analysis was performed from October 2020 to May 2021. MAIN OUTCOMES AND MEASURES Secular trends in HPV vaccine safety concerns and spontaneous AE reporting for HPV vaccination from 2015 to 2018. RESULTS Caregivers of 39 364 unvaccinated adolescents with a mean (SD) age of 15.57 (0.08) years (26 996 White adolescents [62.9%], 22 707 male adolescents [56.1%], 11 392 privately insured [62.6%], and 32 674 above the poverty level [79.3%]) reported their reasons for not initiating the HPV vaccine series in the 2015-2018 NIS. Citing safety concerns as the primary reason for not initiating the HPV vaccine series increased from 13.0% (95% CI, 12.1%-14.0%) in 2015 to 23.4% (95% CI, 21.8%-25.0%) in 2018 (P for trend < .001), equating to a change from 170 046 to 259 157 US adolescents not initiating the vaccine because of safety concerns. The proportion of parents citing safety concerns as the main reason for HPV vaccine hesitancy increased in 30 states. The largest increases (more than 200%) were observed in California, Hawaii, South Dakota, and Mississippi. During 2015 to 2018, 16 621 AE reports following HPV vaccination were reported to VAERS. The AE reporting rate per 100 000 doses distributed decreased from 44.7 in 2015 to 29.4 in 2018 (P for trend < .001). The serious AE reporting rate, including those leading to hospitalizations, disability, life-threatening condition, or death did not change. CONCLUSIONS AND RELEVANCE In this descriptive cross-sectional study, a rise in citing safety concerns was observed among parents with HPV vaccine hesitancy, contrary to the nonserious and serious AE reporting trends. These findings suggest an urgent need to combat the rising sentiment of safety concerns among caregivers to increase HPV vaccine confidence.
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Affiliation(s)
- Kalyani Sonawane
- Center for Healthcare Data, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
- Center for Health Services Research, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
| | - Yueh-Yun Lin
- Center for Health Services Research, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
| | - Haluk Damgacioglu
- Center for Health Services Research, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
| | - Yenan Zhu
- Center for Health Services Research, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
| | - Maria E Fernandez
- Center for Health Promotion and Prevention Research, UTHealth School of Public Health, Houston, Texas
| | | | - Cecilia Ganduglia Cazaban
- Center for Healthcare Data, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
| | - Ruosha Li
- Department of Biostatistics and Data Science, School of Public Health, UT Health Science Center at Houston, Houston, Texas
| | - David R Lairson
- Center for Health Services Research, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
| | - Ying Lin
- Department of Industrial Engineering, University of Houston, Houston, Texas
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
| | - Ashish A Deshmukh
- Center for Healthcare Data, Department of Management, Policy, and Community Health, UTHealth School of Public Health, Houston, Texas
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Bhagianadh D, Arora K. COVID-19 Vaccine Hesitancy Among Community-Dwelling Older Adults: The Role of Information Sources. J Appl Gerontol 2021; 41:4-11. [PMID: 34365856 DOI: 10.1177/07334648211037507] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite high enthusiasm surrounding the rollout of the COVID-19 vaccine, some older adults continue to remain hesitant about its receipt. There is limited evidence on vaccine hesitancy among community-dwelling older adults. In this study, we examine the prevalence and predictors (particularly the role played by information sources) of vaccine hesitancy in this group. We use the Medicare Current Beneficiary Survey and employ multivariable logistic regression models to explore this. Relative to those relying on regular news, those depending on health care providers (HCPs), social media, other internet/webpages, and family/friends as the main information source on COVID-19 expressed higher negative vaccine intent. The high negative intent with HCPs as the main information source should be interpreted with caution. This could be reflective of the timing of the survey and changing attitude toward the vaccine among HCPs themselves.
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Shah S. Children and the American Rescue Plan: countering COVID-19 vaccine hesitancy during a global pandemic. Pediatr Res 2021; 90:237-239. [PMID: 34035429 PMCID: PMC8147585 DOI: 10.1038/s41390-021-01590-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/10/2021] [Indexed: 01/10/2023]
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Ansari B. Information seeking behaviour differences indicate which US population groups lack information about human papilloma virus and associated cancer risks. Health Info Libr J 2021; 40:42-53. [PMID: 34297451 DOI: 10.1111/hir.12393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 06/14/2021] [Accepted: 06/29/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND The majority of the US population have poor knowledge of cancers related to human papillomavirus (HPV). Identifying best sources for communicating this information can guide strategies to promote HPV vaccination. OBJECTIVES To assess the relationship between sources of health information and individuals' knowledge of HPV-related cervical and oropharyngeal cancer. METHODS This study conducts logistic regression on the most recent wave (2019) of the Health Information National Trends Survey. Dependent variables are indicators for self-reported awareness that HPV causes (a) cervical cancer and (b) oropharyngeal cancer. The primary indicator is a variable for different sources of health information: The Internet, professional sources, print materials, friends/family and never looked for health information. RESULTS Being female, young, non-Hispanic White and having college education is associated with higher odds of knowing about HPV-related cervical cancer. Controlling for demographic factors, individuals using professionals and the Internet are more likely to know that HPV causes cervical cancer (aOR: 2.65, 95% CI: 1.66, 4.25; aOR: 2.47, 95% CI: 1.75, 3.50, respectively) compared to those who have never looked for health information. Similar results were found for HPV-related oropharyngeal cancer. CONCLUSION Findings provide implications for targeted messaging through effective channels to improve HPV vaccination uptake.
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Affiliation(s)
- Bahareh Ansari
- Department of Information Science, University at Albany-State University of New York, Albany, New York, USA
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Massey PM, Togo E, Chiang SC, Klassen AC, Rose M, Manganello JA, Leader AE. Identifying HPV vaccine narrative communication needs among parents on social media. Prev Med Rep 2021; 23:101488. [PMID: 34295614 PMCID: PMC8281599 DOI: 10.1016/j.pmedr.2021.101488] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/17/2021] [Accepted: 07/03/2021] [Indexed: 11/18/2022] Open
Abstract
Sharing personal experiences is an important communication strategy in public health, including vaccination. This study sought to understand if parents would be receptive to learning about the HPV vaccine from other parent experiences, and what format this information should take on social media. In May 2020, we conducted a qualitative study of six online focus groups across the U.S. with parents (n = 48) of children ages 9–14. Using a text-based discussion format, we discussed their experiences getting information about the HPV vaccine and using Twitter to learn about health topics. Four coders structured qualitative findings by themes including content, delivery, and source of information. An accompanying survey was used to describe participant Twitter use and HPV vaccine knowledge and attitudes. The average participant age was 44.6 years old, 63% were mothers, and the majority had high HPV vaccine knowledge. Parents indicated that they want to hear from other parents about their experiences with the HPV vaccine. However, it was hard to know where to find this information. When experiences are shared on social media, the negative ones are more memorable and more personal. Parents thought Twitter could be an important space to communicate about the HPV vaccine if it was done in a credible, verifiable, and authentic way. Parents want to learn about the HPV vaccine through other parent experiences, especially when this aligns with science supporting the vaccine. Public health and medical communities must embrace this mix of evidence and lived experiences to deliver and discuss health information.
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Affiliation(s)
- Philip M. Massey
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, United States
- Corresponding author at: Department of Community Health and Prevention, Dornsife School of Public Health, 3215 Market St., Philadelphia, PA 19104, United States.
| | - Elikem Togo
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, United States
| | - Shawn C. Chiang
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, United States
| | - Ann C. Klassen
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, United States
| | - Meredith Rose
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, United States
| | - Jennifer A. Manganello
- Department and Health Policy, Management, and Behavior, School of Public Health, Albany University, United States
| | - Amy E. Leader
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, United States
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Colón-López V, Rivera-Figueroa V, Arroyo-Morales GO, Medina-Laabes DT, Soto-Abreu R, Rivera-Encarnación M, Díaz-Miranda OL, Ortiz AP, Wells KB, Vázquez-Otero C, Hull PC. Content analysis of digital media coverage of the human papillomavirus vaccine school-entry requirement policy in Puerto Rico. BMC Public Health 2021; 21:1286. [PMID: 34210308 PMCID: PMC8248762 DOI: 10.1186/s12889-021-11311-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 06/18/2021] [Indexed: 11/10/2022] Open
Abstract
Background In August 2018, Puerto Rico (PR) became the 4th state or territory in the United States to adopt a human papillomavirus (HPV) vaccine school-entry requirement, for students 11–12 years old. Evidence suggests that the content of media coverage may impact people’s perception of HPV vaccine and their willingness to vaccinate. This study aimed to analyze the content of digital news coverage related to the implementation of the policy in PR. Methods A content review was conducted of digital media published from January 2017 through December 2018. The content reviewed was carried out in two steps: 1) creating a matrix to summarize each article’s content about the policy and 2) qualitative analysis using a grounded theory approach. Results The search resulted in 34 articles obtained from 17 online local and international news outlets that reported the policy's implementation. Analyses showed that 61% of the news articles did not mention the number of required doses, and 79% discussed the new policy concerning cancer prevention. In 2017, news coverage focused mostly on describing the policy, while 2018 coverage focused on controversies surrounding the implementation. Neutral emergent codes included: 1) Description of the policy; 2) Information about HPV related cancers; and 3) General information about HPV vaccine. Negative emergent codes included: 1) infringement to patient and parental autonomy; 2) Hesitancy from the political sector, and 3) Hesitancy from groups and coalitions. Positive content included: 1) knowledge and acceptance of HPV vaccine for cancer prevention; 2) importance of education and protective sexual behaviors; and 3) new vaccination law proposal. Conclusions Most of the media coverage in PR was neutral and included limited information related to the vaccine, HPV, and HPV-related cancers. Neutral and negative themes could influence public concerns regarding the new policy, as well as HPV vaccination rates in PR.
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Affiliation(s)
- Vivian Colón-López
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico. .,Department of Health Services Administration, Evaluation Research of Health Systems Science Program, School of Public Health, Medical Science Campus, University of Puerto Rico, PO Box 365067, San Juan, 00936-5067, Puerto Rico.
| | - Vilnery Rivera-Figueroa
- Department of Health Services Administration, Evaluation Research of Health Systems Science Program, School of Public Health, Medical Science Campus, University of Puerto Rico, PO Box 365067, San Juan, 00936-5067, Puerto Rico
| | - Glizette O Arroyo-Morales
- Department of Health Services Administration, Evaluation Research of Health Systems Science Program, School of Public Health, Medical Science Campus, University of Puerto Rico, PO Box 365067, San Juan, 00936-5067, Puerto Rico
| | - Diana T Medina-Laabes
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico
| | - Roxana Soto-Abreu
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico
| | - Manuel Rivera-Encarnación
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico
| | - Olga L Díaz-Miranda
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico
| | - Ana P Ortiz
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico.,Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, PO Box 70184, San Juan, 00936-8184, Puerto Rico
| | - Katelyn B Wells
- Association of Immunization Managers, 620 Hungerford Dr. Suite 29, Rockville, MD, 20850, USA
| | - Coralia Vázquez-Otero
- Harvard T.H. Chan School of Public Health Dana-Farber Cancer Institute, NCI Postdoctoral Fellow, 450 Brookline Ave., LW 633, Boston, MA, 02215, USA
| | - Pamela C Hull
- Department of Behavioral Science, College of Medicine, Markey Cancer Center, University of Kentucky, 2365 Harrodsburg Rd, Suite A230, Lexington, KY, 40504-3381, USA
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41
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Furini M. Identifying the features of ProVax and NoVax groups from social media conversations. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2021.106751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cataldi JR, O'Leary ST, Markowitz LE, Allison MA, Crane LA, Hurley LP, Brtnikova M, Beaty BL, Gorman C, Meites E, Lindley MC, Kempe A. Changes in Strength of Recommendation and Perceived Barriers to Human Papillomavirus Vaccination: Longitudinal Analysis of Primary Care Physicians, 2008-2018. J Pediatr 2021; 234:149-157.e3. [PMID: 33689710 PMCID: PMC10207027 DOI: 10.1016/j.jpeds.2021.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate among pediatricians and family physicians human papillomavirus (HPV) vaccination recommendation practices for 11- to 12-year-old youth; report parental refusal/deferral of HPV vaccination; and report barriers to HPV vaccination changed over time. STUDY DESIGN We surveyed nationally representative networks of pediatricians and family physicians in 2008, 2010, 2013-2014, and 2018. Male vaccination questions were not asked in 2008; barriers and parental vaccine refusal questions were not asked in 2010. RESULTS Response rates were 80% in 2008 (680/848), 72% in 2010 (609/842), 70% in 2013-2014 (582/829), and 65% in 2018 (588/908). The proportion of physicians strongly recommending HPV vaccination for 11- to 12-year-old patients increased from 53% in 2008 to 79% in 2018 for female patients and from 48% in 2014 to 76% in 2018 for male patients (both P < .0001). The proportion of physicians indicating ≥50% of parents refused/deferred HPV vaccination remained steady for female patients (24% in 2008 vs 22% in 2018, P = .40) and decreased for male patients (42% in 2014 vs 28% in 2018, P < .001). Physician barriers to providing HPV vaccination were rare and decreased over time. Increasing numbers of physicians reported perceived parental barriers of vaccine safety concerns (5% "major barrier" in 2008 vs 35% in 2018, P < .0001) and moral/religious concerns (5% in 2008 vs 25% in 2018, P < .0001). CONCLUSIONS Between 2008 and 2018, more primary care physicians reported recommending HPV vaccination for adolescents, fewer reported barriers, and more physicians reported parents who had vaccine safety or moral/religious concerns.
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Affiliation(s)
- Jessica R Cataldi
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Sean T O'Leary
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Lauri E Markowitz
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Mandy A Allison
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Lori A Crane
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Laura P Hurley
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Division of General Internal Medicine, Denver Health, Denver, CO
| | - Michaela Brtnikova
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Brenda L Beaty
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO
| | - Carol Gorman
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO
| | - Elissa Meites
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Megan C Lindley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Allison Kempe
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO; Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
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Argyris YA, Monu K, Tan PN, Aarts C, Jiang F, Wiseley KA. Using Machine Learning to Compare Provaccine and Antivaccine Discourse Among the Public on Social Media: Algorithm Development Study. JMIR Public Health Surveill 2021; 7:e23105. [PMID: 34185004 PMCID: PMC8277307 DOI: 10.2196/23105] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/31/2020] [Accepted: 05/12/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Despite numerous counteracting efforts, antivaccine content linked to delays and refusals to vaccinate has grown persistently on social media, while only a few provaccine campaigns have succeeded in engaging with or persuading the public to accept immunization. Many prior studies have associated the diversity of topics discussed by antivaccine advocates with the public's higher engagement with such content. Nonetheless, a comprehensive comparison of discursive topics in pro- and antivaccine content in the engagement-persuasion spectrum remains unexplored. OBJECTIVE We aimed to compare discursive topics chosen by pro- and antivaccine advocates in their attempts to influence the public to accept or reject immunization in the engagement-persuasion spectrum. Our overall objective was pursued through three specific aims as follows: (1) we classified vaccine-related tweets into provaccine, antivaccine, and neutral categories; (2) we extracted and visualized discursive topics from these tweets to explain disparities in engagement between pro- and antivaccine content; and (3) we identified how those topics frame vaccines using Entman's four framing dimensions. METHODS We adopted a multimethod approach to analyze discursive topics in the vaccine debate on public social media sites. Our approach combined (1) large-scale balanced data collection from a public social media site (ie, 39,962 tweets from Twitter); (2) the development of a supervised classification algorithm for categorizing tweets into provaccine, antivaccine, and neutral groups; (3) the application of an unsupervised clustering algorithm for identifying prominent topics discussed on both sides; and (4) a multistep qualitative content analysis for identifying the prominent discursive topics and how vaccines are framed in these topics. In so doing, we alleviated methodological challenges that have hindered previous analyses of pro- and antivaccine discursive topics. RESULTS Our results indicated that antivaccine topics have greater intertopic distinctiveness (ie, the degree to which discursive topics are distinct from one another) than their provaccine counterparts (t122=2.30, P=.02). In addition, while antivaccine advocates use all four message frames known to make narratives persuasive and influential, provaccine advocates have neglected having a clear problem statement. CONCLUSIONS Based on our results, we attribute higher engagement among antivaccine advocates to the distinctiveness of the topics they discuss, and we ascribe the influence of the vaccine debate on uptake rates to the comprehensiveness of the message frames. These results show the urgency of developing clear problem statements for provaccine content to counteract the negative impact of antivaccine content on uptake rates.
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Affiliation(s)
| | - Kafui Monu
- School of Business, University of Northern British Columbia, Prince George, BC, Canada
| | - Pang-Ning Tan
- Michigan State University, East Lansing, MI, United States
| | - Colton Aarts
- Department of Computer Science, University of Northern British Columbia, Prince George, BC, Canada
| | - Fan Jiang
- Department of Computer Science, University of Northern British Columbia, Prince George, BC, Canada
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Galvin AM, Garg A, Moore JD, Litt DM, Thompson EL. Quality over quantity: human papillomavirus vaccine information on social media and associations with adult and child vaccination. Hum Vaccin Immunother 2021; 17:3587-3594. [PMID: 34086517 DOI: 10.1080/21645515.2021.1932219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Human Papillomavirus (HPV) vaccination is recommended for adults aged 27-45 as a shared clinical decision with their healthcare provider. With the rise of social media as a vaccine information source, this study examined the extent of exposure to HPV vaccine content by social media platform and evaluated associations between HPV vaccine content on social media and HPV vaccine intent among both 27-45 year olds and their eligible children. U.S. participants (51% women, 9% Black, 8% Hispanic/Latinx), aged 27-45, were cross-sectionally surveyed online from April to May 2020 (n = 691). Outcomes included HPV vaccination intention (intend/do not intend) for themselves and, among participants with unvaccinated children aged 9-17 (n = 223), their eligible children. Adjusted odds ratios for HPV vaccine content and both outcomes were calculated. Extent of HPV vaccination exposure on social media was not associated with intention to vaccinate for HPV. Seeing mostly negative/mixed information about the HPV vaccine on social media was associated with lower odds of vaccination intention for adults (aOR = 0.34, 95% CI 0.15, 0.79) and adolescents (aOR = 0.34, 95% CI 0.21, 0.53). Viewing HPV vaccine information from social media as not credible was associated with lower odds of vaccine intent for adults (aOR = 0.17, 95% CI 0.07, 0.41) and adolescents (aOR = 0.16, 95% CI 0.10, 0.29). Although extent of HPV vaccine exposure on social media was not associated with vaccination outcomes, findings support developing quality social media strategies that increase the dissemination of positive and credible information in favor of HPV vaccination.
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Affiliation(s)
- Annalynn M Galvin
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Ashvita Garg
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Jonathan D Moore
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Dana M Litt
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Erika L Thompson
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA
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Calo WA, Gilkey MB, Shah PD, Dyer AM, Margolis MA, Dailey SA, Brewer NT. Misinformation and other elements in HPV vaccine tweets: an experimental comparison. J Behav Med 2021; 44:310-319. [PMID: 33528744 PMCID: PMC8131262 DOI: 10.1007/s10865-021-00203-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 01/12/2021] [Indexed: 12/20/2022]
Abstract
Our study examined how misinformation and other elements of social media messages affect antecedents to human papillomavirus (HPV) vaccination of adolescents. In 2017-2018, we randomly assigned a national sample of 1206 U.S. parents of adolescents to view one tweet using a 2 × 2 × 2 × 2 between-subjects factorial experiment. The 16 experimental tweets varied four messaging elements: misinformation (misinformation or not), source (person or organization), narrative style (storytelling or scientific data), and topic (effectiveness or safety). Parents reported their motivation to vaccinate (primary outcome), trust in social media content, and perceived risk about HPV-related diseases. Tweets without misinformation elicited higher HPV vaccine motivation than tweets with misinformation (25% vs. 5%, OR = 6.60, 95% CI:4.05, 10.75). Motivation was higher for tweets from organizations versus persons (20% vs. 10%, OR = 2.47, 95% CI:1.52, 4.03) and about effectiveness versus safety (20% vs. 10%, OR = 2.03, 95% CI:1.24, 3.30). Tweets with misinformation produced lower trust and higher perceived risk (both p < .01), with impact varying depending on source and topic. In conclusion, misinformation was the most potent social media messaging element. It may undermine progress in HPV vaccination.
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Affiliation(s)
- William A Calo
- Department of Public Health Sciences, Penn State College of Medicine, 90 Hope Drive, Mail Code A210, Hershey, PA, 17033, USA.
- Penn State Cancer Institute, Hershey, PA, USA.
| | - Melissa B Gilkey
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Parth D Shah
- The Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Anne-Marie Dyer
- Department of Public Health Sciences, Penn State College of Medicine, 90 Hope Drive, Mail Code A210, Hershey, PA, 17033, USA
| | - Marjorie A Margolis
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Susan Alton Dailey
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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46
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Argyris YA, Kim Y, Roscizewski A, Song W. The mediating role of vaccine hesitancy between maternal engagement with anti- and pro-vaccine social media posts and adolescent HPV-vaccine uptake rates in the US: The perspective of loss aversion in emotion-laden decision circumstances. Soc Sci Med 2021; 282:114043. [PMID: 34147269 DOI: 10.1016/j.socscimed.2021.114043] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/05/2021] [Accepted: 05/13/2021] [Indexed: 01/01/2023]
Abstract
While Human Papillomavirus (HPV) is a prominent cause of cervical cancer and mortality among underserved women, HPV vaccine completion rates remain stagnant (54%) among US adolescents. Our objective is to identify how adolescents' mothers' engagement with anti-vaccine versus pro-vaccine social media content is associated with their children's HPV vaccination rates via increased vaccine hesitancy. We employ the notion of loss aversion escalated in an emotion-laden circumstance in consumer behavior literature given that HPV vaccination decisions directly affect children's well-being. Based on this escalated loss aversion tendency for an emotion-laden decision, we explain why anti-vaccine content disproportionately increases mothers' overarching vaccine hesitancy, while pro-vaccine content does not decrease vaccine hesitancy. We conducted a population-based survey among 426 mothers of US adolescents aged 13-18. Our sample closely mimics the socioeconomic and demographic factors of the population group of mothers of adolescents in the US census. Our results show that anti-vaccine social media posts are associated with increases in mothers' overarching vaccine hesitancy and with decreases in their children's HPV vaccination rates, while pro-vaccine content has no significant association with either.
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Affiliation(s)
- Young Anna Argyris
- Department of Media and Information, College of Communication Arts and Sciences, Michigan State University, East Lansing, MI, USA.
| | - Yongsuk Kim
- Department of Fintech, Sungkyunkwan University, Seoul, South Korea
| | - Alexa Roscizewski
- Department of Communication, College of Arts and Sciences, University of Delaware, Newark, DE, USA
| | - Won Song
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA
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47
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Piltch-Loeb R, Savoia E, Goldberg B, Hughes B, Verhey T, Kayyem J, Miller-Idriss C, Testa M. Examining the effect of information channel on COVID-19 vaccine acceptance. PLoS One 2021; 16:e0251095. [PMID: 33979370 PMCID: PMC8116041 DOI: 10.1371/journal.pone.0251095] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/19/2021] [Indexed: 11/18/2022] Open
Abstract
Hesitancy towards the COVID-19 vaccine remains high among the US population. Now that the vaccine is available to priority populations, it is critical to convince those that are hesitant to take the vaccine. Public health communication about the vaccine as well as misinformation on the vaccine occurs through a variety of different information channels. Some channels of information are more commonly found to spread misinformation. Given the expansive information environment, we sought to characterize the use of different media channels for COVID-19 vaccine information and determine the relationship between information channel and vaccine acceptance. We used quota sampling of vaccine priority groups [N = 2,650] between December 13 and 23, 2020 and conducted bivariate chi-squared tests and multivariable multinomial logistic regression analyses to determine the relative impact of channels of information on vaccine acceptance. We found traditional channels of information, especially National TV, National newspapers, and local newspapers increased the likelihood of vaccine acceptance. Individuals who received information from traditional media compared to social media or both traditional and social media were most likely to accept the vaccine. The implications of this study suggest social media channels have a role to play in educating the hesitant to accept the vaccine, while traditional media channels should continue to promote data-driven and informed vaccine content to their viewers.
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Affiliation(s)
- Rachael Piltch-Loeb
- Division of Policy Translation & Leadership Development, Emergency Preparedness Research Evaluation & Practice [EPREP] Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Elena Savoia
- Division of Policy Translation & Leadership Development, Emergency Preparedness Research Evaluation & Practice [EPREP] Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Beth Goldberg
- Jigsaw, Google LLC, New York, New York, United States of America
| | - Brian Hughes
- Center for University Excellence [CUE] and Polarization and Extremism Research and Innovation Lab [PERIL], American University, Washington, DC, United States of America
| | - Tanner Verhey
- Trust and Safety, Google LLC, Sunnyvale, California, United States of America
| | - Juliette Kayyem
- Harvard Kennedy School, Harvard University, Cambridge, Massachusetts, United States of America
| | - Cynthia Miller-Idriss
- Center for University Excellence [CUE] and Polarization and Extremism Research and Innovation Lab [PERIL], American University, Washington, DC, United States of America
| | - Marcia Testa
- Division of Policy Translation & Leadership Development, Emergency Preparedness Research Evaluation & Practice [EPREP] Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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48
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Margolis MA, Brewer NT, Shah PD, Calo WA, Alton Dailey S, Gilkey MB. Talking about recommended age or fewer doses: what motivates HPV vaccination timeliness? Hum Vaccin Immunother 2021; 17:3077-3080. [PMID: 33961539 DOI: 10.1080/21645515.2021.1912550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
HPV vaccination is recommended for U.S. adolescents at ages 11-12 and requires two versus three doses if the series is started before age 15. We evaluated how talking about recommended age or fewer doses motivates on-time HPV vaccination. Our national, online experiment randomized 1,263 parents of adolescents to view one of three messages about HPV vaccination recommendations or no message. Messages framed guidelines as recommending: vaccination at age 11-12; fewer doses for those who start vaccination at age 11-12; or, fewer doses for those who start vaccination before age 15. We then assessed parents' preferred age for HPV vaccination, categorizing preferences of ≤12 years as on-time. Parents who viewed "at age 11-12" versus no message more often preferred on-time HPV vaccination (63% vs. 43%, p < .05) and did not differ from those viewing "fewer doses at age 11-12" (63% vs. 64%, p > .05). Parents who viewed "fewer doses before age 15" less often preferred on-time HPV vaccination (39%, p < .05). Recommending HPV vaccination at age 11-12 encouraged on-time vaccination, while offering fewer doses had little impact. Providers should avoid framing HPV vaccination guidelines in reference to age 15 because doing so may discourage on-time vaccination by introducing confusion about the recommended age.
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Affiliation(s)
- Marjorie A Margolis
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Parth D Shah
- Public Health Sciences Division, Hutchinson Institute for Cancer Outcomes Research, Seattle, WA, USA
| | - William A Calo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.,Penn State Hershey Cancer Institute, Hershey, PA, USA
| | - Susan Alton Dailey
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Melissa B Gilkey
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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49
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Harrington N, Chen Y, O'Reilly AM, Fang CY. The role of trust in HPV vaccine uptake among racial and ethnic minorities in the United States: a narrative review. AIMS Public Health 2021; 8:352-368. [PMID: 34017897 PMCID: PMC8116180 DOI: 10.3934/publichealth.2021027] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/31/2021] [Indexed: 11/23/2022] Open
Abstract
Despite the clinically proven benefits of the human papillomavirus (HPV) vaccine in preventing cervical and other HPV-associated cancers, vaccination coverage has been suboptimal among adolescents and young adults in the United States (US), particularly among racial and ethnic minority adolescents. Historical legacies, combined with current racial/ethnic disparities in healthcare, may contribute to suboptimal uptake and completion of the HPV vaccine in part through differing levels of trust in doctors and healthcare institutions. The purpose of this narrative review was to characterize trust and its role in decision making about HPV vaccine uptake among US racial and ethnic minorities. We conducted a literature search using the PubMed database, and our search terms yielded 1176 articles. We reviewed 41 full-text articles for eligibility and included 20 articles in this review. These studies used varied measures of trust or mistrust and assessed trust in not only doctors/healthcare providers, but also other sources including pharmaceutical companies, media, and clergy. Our review findings revealed generally high levels of trust in doctors and healthcare providers, but less so in pharmaceutical companies. Mistrust of either healthcare providers, government agencies or pharmaceutical companies was consistently associated with less favorable attitudes and lower vaccine uptake. The downstream effects of mistrust may occur through selected health beliefs regarding the perceived efficacy and safety of the vaccine. Minority groups were more likely to report trust in family members, religious organizations, and media sources compared to their white counterparts. Decision making about vaccine uptake is a multilayered process that involves comparing the perceived benefits of the vaccine against its perceived risks. Understanding how trusted sources can effectively harness the tools of social and traditional media to increase knowledge and awareness may help combat misinformation about the HPV vaccine and improve engagement with diverse communities.
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Affiliation(s)
- Nicole Harrington
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Yuku Chen
- Cancer Prevention & Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Alana M O'Reilly
- Molecular Therapeutics Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Carolyn Y Fang
- Cancer Prevention & Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
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50
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Sundstrom B, Cartmell KB, White AA, Well H, Pierce JY, Brandt HM. Correcting HPV Vaccination Misinformation Online: Evaluating the HPV Vaccination NOW Social Media Campaign. Vaccines (Basel) 2021; 9:352. [PMID: 33917512 PMCID: PMC8067464 DOI: 10.3390/vaccines9040352] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 11/16/2022] Open
Abstract
The human papillomavirus (HPV) vaccine provides protection from six HPV-related cancers. Approximately half of South Carolina adolescents have not completed the vaccination series, representing a missed opportunity to prevent cancer. The HPV Vaccination NOW: This is Our Moment social media campaign is an initiative of the South Carolina Cancer Alliance (SCCA) and Hollings Cancer Center at the Medical University of South Carolina (MUSC). This statewide social media campaign aimed to increase parental awareness of and build vaccine confidence around HPV vaccination in S.C. The ten-week campaign was strategically implemented between June and August 2019 to encourage HPV vaccination at back-to-school medical appointments. A process evaluation showed that the campaign resulted in over 370,000 total impressions, reached over 33,000 individuals, and culminated with over 1122 followers. There were over 2700 engagements on Facebook and Twitter. A qualitative content analysis indicated that pro-vaccine and anti-vaccine comments were dominated by personal stories. Comments promoting misinformation about the HPV vaccine were often countered through peer-to-peer dialogue. Findings suggest that creating opportunities for the target audience to engage with campaign messages effectively corrected misinformation.
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Affiliation(s)
- Beth Sundstrom
- Department of Communication, College of Charleston, Charleston, SC 29424, USA
| | - Kathleen B. Cartmell
- Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA;
| | - Ashley A. White
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA;
| | - Henry Well
- South Carolina Cancer Alliance, Columbia, SC 29204, USA;
| | | | - Heather M. Brandt
- St. Jude Children’s Research Hospital and Comprehensive Cancer Center, Memphis, TN 38105, USA;
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