The COVID-19 social media infodemic

Caregivers' perceptions on routine childhood vaccination: A qualitative study on vaccine hesitancy in a South Brazil state capital

Immunization programs worldwide have been facing challenges in keeping vaccination coverage high. Even though universally known for its robust National Immunization Program, Brazil has also faced significant challenges regarding vaccination coverage. One of the reasons for this is vaccine hesitancy, a complex, multi-causal, and context-specific phenomenon. This qualitative study aims to understand the factors associated with decision-making and the drivers of vaccine hesitancy in Florianopolis, Santa Catarina state capital, regarding caregivers' perceptions of routine childhood vaccination. In-depth interviews were conducted in the Capital city of Santa Catarina State. Families with children up to 6 years old were included. Data were analyzed based on thematic content analysis. Twenty-nine caregivers in 18 families were interviewed. These caregivers were mainly mothers and fathers. Three themes emerged: 1. Access to information and the decision-making process, where we discuss the role of social circles, healthcare workers, and the internet; 2. Individual-institutions power relationships: Perceptions about the State's role and the Health institutions: 3. Reasons and motivations: The senses and meanings behind non-vaccination, where we discuss the drivers of vaccine hesitancy related to risk perception, caregivers' opinions on the medical-pharmaceutical industry, vaccines' composition and their side effects, families' lifestyles and worldviews, and the childhood routine vaccination schedule. The results of this study reaffirm the complexity of the decision-making process in childhood vaccination and further enable a better contextual understanding of the complex and challenging phenomenon of vaccine hesitancy.

Supporting parents with acutely ill children: Environment scan and user evaluation of mobile applications (the SuPa kids project)

BACKGROUND

Children are one of the biggest users of emergency departments in the UK, sometimes utilising services when experiencing acute illnesses that can be managed at home. mHealth can be an efficacious way for parents/guardians to manage acute illnesses. It has also become a ubiquitous resource to promote public health interests within a resource constrained health system. However, to be effective, co-design is necessary with concepts such as usefulness, ease of use, trustworthiness and security underpinning the utility of mHealth interventions for acute childhood illness.

OBJECTIVE

The objective of this study was to conduct an environmental scan of mHealth apps for parental assessment and management of acute childhood illnesses in 0- to 5-year-olds, review the content and functionality of each identified app against the list of desired attributes identified in previous research and synthesise publicly available reviews from end users to demonstrate the quality of current apps in the marketplace and identify areas for improvement.

METHOD

App characteristics were mapped to an a priori defined list of desirable attributes. End user reviews were mapped to a modified Technology Acceptance Model framework that included overarching themes of: Perceived Usefulness (PU), Perceived Ease of Use (PEU), Perceived Trustworthiness (PT) and Perceived Security (PS) using reflexive thematic analysis.

RESULTS

Overall, 15 apps were included in the analysis (Table 2). Fourteen of the 15 apps were available on both the iOS and Android platforms. 'Baby Illness, Prevention, Cure' was only available on the Android store. All apps were free to download and did not restrict access to information or features via in-app purchases. Baby and child first aid (British Red Cross) was the earliest app to be released (2014). This app was updated annually, with the most recent update being 2022. The most recent apps to be released (2018) were 'AskFirst' (formerly Ask NHS), 'Essex Child Health' and 'The Lullaby Trust Baby Check', updated in 2022, 2020 and 2019, respectively. No individual app met all the desirable attributes highlighted by parents in previous research. Both 'Healthier Together', and 'The Lullaby Trust Baby Check' included all but one desirable attributes (video), as did the ''CATCH (Common Approach to Children's Health), which did not utilise a traffic light system. Apps that were locality specific were not rated by users (Berkshire Child Health, Cheshire Child Health, Child Health Guide Newham, Child Health HMR, Oldham Child Illness and Walsall Healthy Child). All other apps were rated from 2/5 to 5/5 stars. When considering localities, the 'CATCH' app was only supported in Halton, Cheshire, Knowsley, Liverpool, St Helens and Vale Royal. Further investigation evidenced no correlation between inclusion of the desirable attributes and app rating.

CONCLUSION

Overall, this research has highlighted several aspects of best practise when developing mHealth apps for the management of acute childhood illnesses, for increasing PU, PEU, PT and PS; and also, places importance on co-design.

Challenges and Reflections on Pandemic Disinformation: The Case of Hydroxychloroquine and the Implications for Global Public Health

This text addresses the implications of misinformation during the COVID-19 pandemic, focusing on the use of hydroxychloroquine (HCQ) and other drugs based on a specific publication. The article titled "Deaths induced by compassionate use of hydroxychloroquine during the first COVID-19 wave: an estimate," published in 2024 in the journal Biomedicine and Pharmacotherapy, reveals 17 000 deaths associated with the inappropriate use of HCQ in 6 countries, excluding Brazil and India. The dissemination of ineffective drugs, the persistence in recommending HCQ in Brazil, and the lack of an effective response from academia underscore the fragility of public health systems under pressure. Transparent communication between the scientific community and the public is vital, particularly considering studies, such as the one published in Nature Communications in 2021, which warns of the risks of chloroquine. The text highlights the influence of social media in spreading unverified information and emphasizes the need for criminal liability for those contributing to the spread of misinformation. It concludes by underlining the importance of learning from past mistakes to build a more resilient and informed future in the field of public health.

Faster and farther towards the abyss: global health accelerators instead of tangible changes

Global health accelerators have become the leading expression of global health engagement and policy. While accelerators seem to be the strategy of the moment, the term is meaningless and devoid of any statement of content. Moreover, acceleration can make social processes too fast to be subject to rational control or governance, especially in an era of (un-)social media, which makes the pace of communication and information. Under the dominance of neoliberalism, acceleration and accelerators pose a particular risk because they encounter a situation in which mankind is moving away from solving vital challenges and addressing their root causes. The fashionable emergence of accelerators cannot inspire confidence in the future trends in global health unless they actually result in tangible change and new approaches to tackling systemic challenges.

Viral Anxiety, Reassurance-Seeking Behavior, and Depression Mediate the Influence of Dysfunctional Self-Focus on Preoccupation With COVID-19 Among Infected Cases

OBJECTIVE

Amid the coronavirus disease 2019 (COVID-19) pandemic, the pervasive threat of infection has heightened public and individual health concerns. In the context of instability, although the dysfunctional aspect of self-focus was prominent, preoccupation with viral infection was greater. This study explored the applicability of a cognitive-behavioral model of hypochondriasis to individuals infected with COVID-19 and assessed whether dysfunctional self-focus were associated with the development of preoccupation.

METHODS

An anonymous online survey was conducted via a professional survey platform in December 2022. Participants' clinical characteristics and responses to rating scales were collected, including Obsession with COVID-19 Scale (OCS), Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Stress and Anxiety to Viral Epidemic-6 items (SAVE-6), Patient Health Questionnaire-2 items (PHQ-2), and Dysfunctional Self-focus Attributes Scale (DSAS).

RESULTS

Among the 265 participants, preoccupation with COVID-19 was predicted using CRBS (β=0.60, p<0.001), SAVE-6 (β=0.20, p=0.007), and PHQ-2 (β=0.13, p<0.001) scores. Mediation analysis revealed that viral anxiety influenced this COVID-19 preoccupation, with the relationship mediated by coronavirus reassurance-seeking behavior. Another analysis indicated that dysfunctional self-focus had a significant total effect on preoccupation with COVID-19. However, its direct impact was statistically insignificant, with the association primarily influenced by three mediating factors: viral anxiety, depression, and reassurance-seeking behavior.

CONCLUSION

Preoccupation with coronavirus is influenced by viral anxiety, depression, and reassurance-seeking behavior. Two mediation analyses showed that the application of the cognitive-behavioral model of hypochondriasis is feasible among COVID-19-infected cases and the association of dysfunctional self-focus with mediating factors. This finding highlights the need for personalized psychological support in managing COVID-19 cases.

Non-suicidal self-injury in the COVID-19 pandemic: results from cross-sectional surveys among Brazilian adults from 2020 to 2023

The multilevel psychosocial stressors associated with COVID-19 pandemic set the stage to investigate risk factors and groups susceptible for non-suicidal self-injury (NSSI). A national sample of 9,929 Brazilian adults aged 36.1 years on average participated in the study. Cross-sectional data were collected in 2020, 2021, 2022, and 2023. NSSI levels were considered high in the total sample (13.2%) when compared to other studies in this context. The variables with the highest explanatory power in the regression models were age, anxiety, and depression. The main risk factors were being younger, living in the South or Southeast regions of Brazil, having lower educational attainment, and having higher rates of anxiety and depression. Respondents had the highest probability of NSSI in 2022. The sustained higher rates of NSSI in 2023 compared to the beginning of the pandemic underscores the need for continuous monitoring and the development of preventive actions for self-injurious behaviors.

Exploring ways to support patients with noncommunicable diseases: A pilot study in Nepal during the COVID-19 pandemic

Global healthcare systems have faced unprecedented strain due to the COVID-19 pandemic, with a profound impact on individuals with non-communicable diseases (NCDs), a scenario particularly pronounced in low-income countries like Nepal. This study aimed to understand the experiences of and challenges faced by patients with NCDs in Nepal during the pandemic, focusing on healthcare service availability and identifying factors affecting healthcare use, with the goal of being prepared for future emergencies. This study utilized a telephonic survey of 102 patients with NCDs and 10 qualitative interviews with healthcare providers in the Kavrepalanchok and Nuwakot districts of Nepal. We used mixed methods, with both qualitative and quantitative approaches. Specifically, multiple correspondence analysis, hierarchical cluster analysis, and classification tree analysis were used as exploratory methods. The study revealed that while 69.6% of the participants reported no difficulty in obtaining medication, other questions revealed that 58.8% experienced challenges in accessing routine medical care. Major barriers, such as fear of infection, unavailability of medicine in rural areas, and lack of transportation, were found through the qualitative interviews. Meanwhile, participants identified innovative strategies, such as telemedicine and community-based awareness programs, as potential facilitators for addressing barriers that arise during pandemic situations such as COVID-19. The COVID-19 pandemic exacerbated challenges in accessing healthcare services for patients with NCDs in Nepal. Our findings suggest the need to design and implement telemedicine services for patients with NCDs, as well as community-based programs that aim to improve health literacy, encourage healthy behavior, prevent development of NCDs, and ensure continuity of care during such crises, especially in countries with limited resources.

The social evolution of COVID-19: pandemics as total social facts

The COVID-19 pandemic was an unprecedented global event in recent history. Beginning with an initial outbreak in Wuhan, China, in December 2019, the virus spread rapidly across the globe, causing millions of deaths and triggering an unprecedented health, economic, and social crisis. The initial response to the outbreak in many countries was the implementation of social distancing measures, including the closure of schools and businesses, the cancellation of mass events, and the banning of travel. These measures were aimed at reducing the virus' spread and preventing health systems from being overwhelmed by the numerous severe COVID-19 cases. However, these measures also had a devastating economic impact, especially on precarious workers and freelancers, as well as those who were unable to work from home. As the pandemic (also considered a syndemic or synergistic epidemic) dragged on, countries adopted more flexible approaches to dealing with the virus, adopting mitigation measures rather than social distancing measures. These included the use of masks, testing and contact tracing, and the opening of businesses and schools with the implementation of additional safety measures. This paper highlights the social consequences of the pandemic, ultimately arguing that it is a total social fact (from the French fait social total), based on Marcel Mauss' categorization, since it encompassed and impacted all facets of human life.

COVID-19 Research in Communication Journals: A Structural Topic Modeling-Assisted Bibliometric Analysis

This article presents a bibliometric analysis of research on COVID-19 health communication. We reviewed and analyzed 1,851 articles published in 170 peer-reviewed communication journals between January 2020 and November 2022, to identify key bibliometric information and major research topics in this rapidly expanding field of research. The distribution of countries indicates that the United States is the most productive country, and researchers from Spain, China and the United Kingdom also play an important role. Health Communication is the most influential journal in terms of research productivity and impact. The analysis of highly cited references demonstrates the interdisciplinary nature of this research field. The topics generated by structural topic modeling show that scholars have responded to a variety of issues in COVID-19 communication, encompassing different levels of health communication, the effects of information dissemination, the impact on the general public as well as vulnerable populations, health preventive behaviors and communication technologies. This study aims to enhance researchers' understanding of the current state of this research field and provide insights for future studies.

Socio-demographic factors and COVID-19 experiences predict perceived social support and social media engagement among college students in the U.S

OBJECTIVE

This study examined socio-demographic characteristics and COVID-19 experiences as concurrent predictors of perceived familial and friend social support, social media use, and socio-emotional motives for electronic communication during the COVID-19 pandemic among college students.

PARTICIPANTS

Participants were 619 emerging adults (18-29-year-olds) currently enrolled at, or recently graduated from, a U.S.-based college or university (Mean age = 21.8, SD = 2.2; 64% female; 60% Non-Hispanic White).

METHODS

Online surveys were administered between May and June 2020. A path analysis model was conducted to examine the concurrent associations between socio-demographic factors, COVID-19-related experiences, social media/electronic engagement, and perceived social support.

RESULTS

Findings indicated significant differences in perceived social support, social media use, and socio-emotional motives for electronic communication as a function of gender, race, sexual orientation, first-generation status, and relationship status.

CONCLUSIONS

Our findings highlight the role of both individual and situational differences in interpersonal functioning and demonstrate how college students differently engaged with social media for socio-emotional purposes during the COVID-19 pandemic.

Cooperation in the Time of COVID

Humans evolved to be hyper-cooperative, particularly when among people who are well known to them, when relationships involve reciprocal helping opportunities, and when the costs to the helper are substantially less than the benefits to the recipient. Because humans' cooperative nature evolved over many millennia when they lived exclusively in small groups, factors that cause cooperation to break down tend to be those associated with life in large, impersonal, modern societies: when people are not identifiable, when interactions are one-off, when self-interest is not tied to the interests of others, and when people are concerned that others might free ride. From this perspective, it becomes clear that policies for managing pandemics will be most effective when they highlight superordinate goals and connect people or institutions to one another over multiple identifiable interactions. When forging such connections is not possible, policies should mimic critical components of ancestral conditions by providing reputational markers for cooperators and reducing the systemic damage caused by free riding. In this article, we review policies implemented during the pandemic, highlighting spontaneous community efforts that leveraged these aspects of people's evolved psychology, and consider implications for future decision makers.

Factors influencing college students' online rumor refuting behavior during major public health crises: the moderating effect of group norms

This study integrates SOR (Stimuli-Organism-Response) theoretical framework and rational behavior theory within a theoretical framework, incorporating group norms as a moderating factor to investigate the psychological mechanisms influencing Chinese college students' online rumor-refutation behavior amidst public health crises. Using the structural equation modeling research method, data was collected via questionnaires from 1,254 participants in the context of the COVID-19 pandemic. The findings indicate that both online and offline information seeking are positively correlated with college students' attitudes and subjective norms. Moreover, the attitudes and subjective norms of college students are positively correlated with the online rumor refuting behavior. Furthermore, group norms serve to strengthen the connection between college students' attitudes and their engagement in online refuting rumors. These results illuminate the psychological underpinnings driving college students' online rumor-refuting actions, offering practical and policy implications for effectively managing rumor behaviors.

Online rumors during the COVID-19 pandemic: co-evolution of themes and emotions

Introduction

During public health emergencies, online rumors spread widely on social media, causing public information anxiety and emotional fluctuations. Analyzing the co-evolution patterns of online rumor themes and emotions is essential for implementing proactive and precise governance of online rumors during such events.

Methods

Rumor texts from mainstream fact-checking platforms during the COVID-19 pandemic were collected and analyzed in phases based on the crisis lifecycle theory. The LDA topic model was applied to analyze the distribution of rumor themes at different stages. The Baidu AI Sentiment Analysis API was used to study the emotional tendencies of rumors at different stages. Line graphs were utilized to analyze the co-evolution characteristics of rumor themes and emotions.

Results

During the COVID-19 pandemic, the themes of online rumors can be categorized into five types: epidemic prevention and control, panic-inducing, production and livelihood, virus dissemination, and social figures. These themes exhibited repetition and fluctuation at different stages of the pandemic. The emotions embedded in pandemic-related online rumors evolved with the progression of the pandemic. Panic-inducing rumors co-evolved with negative emotions, while epidemic prevention and control rumors co-evolved with positive emotions.

Conclusion

The study results help to understand the public's focus and emotional tendencies at different stages of the COVID-19 pandemic, thereby enabling targeted public opinion guidance and crisis management.

COVID-19 impacts and inequities among underserved communities with diabetes

Background

People with diabetes have higher COVID-19 morbidity and mortality. These risks are amplified for underserved communities including racial/ethnic minorities and people with lower socioeconomic status. However, limited research has examined COVID-19 outcomes specifically affecting underserved communities with diabetes.

Methods

From November 2021 to July 2022, adults with insulin-requiring diabetes at federally qualified health centers in Florida and California (n = 450) completed surveys examining COVID-19 outcomes and demographics. Surveys assessed COVID-19 severity, vaccination uptake, mask-wearing habits, income changes, and healthcare access changes. Surveys also included the full Coronavirus Anxiety Scale (CAS-19). Descriptive statistics were computed for all outcomes. Between-group comparisons for state and race/ethnicity were evaluated via Chi-Squared, Fisher's Exact, Cochran-Mantel-Haenszel, One-Way ANOVA, and t-tests. Logistic regression determined factors associated with COVID-19 vaccination uptake. Data were self-reported and analyzed cross-sectionally.

Results

Overall, 29.7 % reported contracting COVID-19; of those, 45.3 % sought care or were hospitalized. Most (81.3 %) received ≥ 1 vaccine. Hispanics had the highest vaccination rate (91.1 %); Non-Hispanic Blacks (NHBs) had the lowest (73.9 %; p =.0281). Hispanics had 4.63x greater vaccination odds than Non-Hispanic Whites ([NHWs]; 95 % CI = [1.81, 11.89]). NHWs least often wore masks (18.8 %; p <.001). Participants reported pandemic-related healthcare changes (62 %) and higher costs of diabetes medications (41 %). Income loss was more frequent in Florida (76 %; p <.001). NHBs most frequently reported "severe" income loss (26.4 %; p =.0124). Loss of health insurance was more common among NHBs (13.3 %; p =.0416) and in Florida (9.7 %; p =.039). COVID-19 anxiety was highest among NHBs and Hispanics (IQR = [0.0, 3.0]; p =.0232) and in Florida (IQR = [0.0, 2.0]; p =.0435).

Conclusions

Underserved communities with diabetes had high COVID-19 vaccine uptake but experienced significant COVID-19-related physical, psychosocial, and financial impacts. NHBs and those in Florida had worse outcomes than other racial/ethnic groups and those in California. Further research, interventions, and policy changes are needed to promote health equity for this population.

Beyond misinformation: developing a public health prevention framework for managing information ecosystems

The COVID-19 pandemic has highlighted how infodemics (defined as an overabundance of information, including misinformation and disinformation) pose a threat to public health and could hinder individuals from making informed health decisions. Although public health authorities and other stakeholders have implemented measures for managing infodemics, existing frameworks for infodemic management have been primarily focused on responding to acute health emergencies rather than integrated in routine service delivery. We review the evidence and propose a framework for infodemic management that encompasses upstream strategies and provides guidance on identifying different interventions, informed by the four levels of prevention in public health: primary, secondary, tertiary, and primordial prevention. On the basis of a narrative review of 54 documents (peer-reviewed and grey literature published from 1961 to 2023), we present examples of interventions that belong to each level of prevention. Adopting this framework requires proactive prevention and response through managing information ecosystems, beyond reacting to misinformation or disinformation.

Quantifying the impact of misinformation and vaccine-skeptical content on Facebook

Low uptake of the COVID-19 vaccine in the US has been widely attributed to social media misinformation. To evaluate this claim, we introduce a framework combining lab experiments (total N = 18,725), crowdsourcing, and machine learning to estimate the causal effect of 13,206 vaccine-related URLs on the vaccination intentions of US Facebook users (N ≈ 233 million). We estimate that the impact of unflagged content that nonetheless encouraged vaccine skepticism was 46-fold greater than that of misinformation flagged by fact-checkers. Although misinformation reduced predicted vaccination intentions significantly more than unflagged vaccine content when viewed, Facebook users' exposure to flagged content was limited. In contrast, unflagged stories highlighting rare deaths after vaccination were among Facebook's most-viewed stories. Our work emphasizes the need to scrutinize factually accurate but potentially misleading content in addition to outright falsehoods.

Choosing a COVID-19 vaccination site might be driven by anxiety and body vigilance

Background

The occurrence of COVID-19 led to the rapid development of several vaccines which were distributed around the world. Even though there had been a vast amount of information about both virus and vaccination, this process was potentially related to increased anxiety and thus affected the vaccination process.

Objective

The present study examined anxiety levels and body vigilance in subjects reporting for COVID-19 vaccination at different vaccination sites.

Methods

Instruments used included general socio-demographic questionnaires and specifically constructed ones such as generalized anxiety disorder (GAD), body vigilance scale (BVS), and coronavirus anxiety scale (CAS).

Results

A total of 227 subjects enrolled in the study reported mild GAD and CAS scores and relatively low scores on BVS. When the subjects were divided according to a vaccination site (under supervision and non-supervised), it turned out that subjects vaccinated under supervision were more anxious (higher GAD and CAS) and had their body vigilance increased.

Conclusion

In conclusion, there is a need for highlighting the importance of efficient planning and organization of vaccination process, since to a certain extent it is driven by both anxiety and body vigilance.

News and misinformation consumption: A temporal comparison across European countries

The Internet and social media have transformed the information landscape, democratizing content access and production. While making information easily accessible, these platforms can also act as channels for spreading misinformation, posing crucial societal challenges. To address this, understanding news consumption patterns and unraveling the complexities of the online information environment are essential. Previous studies highlight polarization and misinformation in online discussions, but many focus on specific topics or contexts, often overlooking comprehensive cross-country and cross-topic analyses. However, the dynamics of debates, misinformation prevalence, and the efficacy of countermeasures are intrinsically tied to socio-cultural contexts. This work aims to bridge this gap by exploring information consumption patterns across four European countries over three years. Analyzing the Twitter activity of news outlets in France, Germany, Italy, and the UK, this study seeks to shed light on how topics of European significance resonate across these nations and the role played by misinformation sources. The results spotlight that while reliable sources predominantly shape the information landscape, unreliable content persists across all countries and topics. Though most users favor trustworthy sources, a small percentage predominantly consumes content from questionable sources, with even fewer maintaining a mixed information diet. The cross-country comparison unravels disparities in audience overlap among news sources, the prevalence of misinformation, and the proportion of users relying on questionable sources. Such distinctions surface not only across countries but also within various topics. These insights underscore the pressing need for tailored studies, crucial in designing targeted and effective countermeasures against misinformation and extreme polarization in the digital space.

Human Papillomavirus Vaccination Acceleration and Introduction in Sub-Saharan Africa: A Multi-Country Cohort Analysis

BACKGROUND

Cervical cancer, caused by human papillomavirus (HPV) infection, is the second-largest cancer killer of women in low- and middle-income countries. The brunt of the global burden is borne predominantly in Sub-Saharan Africa. In 2020 alone, 70,000 of the 100,000 infected women in Africa died from it, thereby making up 21% of global cervical cancer mortality. The introduction of the HPV vaccine into the National Immunization Program was expected to change the trajectory. However, uptake of the vaccination has been poor, especially for the second dose. Only about half of the countries in Africa currently provide the vaccine. Without urgent intervention, the 2030 global cervical cancer elimination targets will be undermined. The study aims to understand the key challenges facing the HPV vaccine and to develop a roadmap to accelerate the uptake.

METHOD

Fourteen countries were purposively included using a cohort design methodology and the investigation spanned March-July 2023. The Africa region was stratified into three focus-group discussion cohorts (Abidjan, Nairobi and Dar es Salaam), comprising pre-selected countries that have already and those about to introduce the HPV vaccine. In each country, the EPI manager, the NITAG chair or representatives and an HPV-focal researcher were selected participants. The methods involved a collaborative and knowledge-sharing format through regional and country-specific discussions, plenary discussions, and workshop-style group missions.

RESULTS

The study reached a total of 78 key stakeholders, comprising 30 participants in cohort one, 21 in cohort two and 27 in cohort three. Key outcomes included the prevalence of declining HPV2 vaccination across all countries in the region; country-specific barriers impeding uptake were identified and strategy for accelerating vaccination demand initiated, e.g., utilizing investments from COVID-19 (e.g., electronic registry and multisector coordination); individual countries developing their respective HPV vaccination recovery and acceleration roadmaps; the identification and inclusion of a zero-dose catch-up strategy into the vaccination roadmaps; support for a transition from multiple-doses to a single-dose HPV vaccine; the incorporation of implementation science research to support the decision-making process such as vaccine choices, doses and understanding behavior.

CONCLUSION

Beyond research, the study shows the significance of scientific approaches that are not limited to understanding problems, but are also solution-oriented, e.g., development of roadmaps to overcome barriers against HPV vaccination uptake.

Assessing Electronic Health Literacy in Individuals With the Post-COVID-19 Condition Using the German Revised eHealth Literacy Scale: Validation Study

BACKGROUND

The eHealth Literacy Scale (eHEALS) is a widely used instrument for measuring eHealth literacy (eHL). However, little is known so far about whether the instrument is valid for the assessment of eHL in persons who are affected by the post-COVID-19 condition. This is particularly important as people with the post-COVID-19 condition are frequently affected by false information from the internet.

OBJECTIVE

The objective of our study was to evaluate the validity and reliability of the German Revised eHealth Literacy Scale (GR-eHEALS) in individuals with the post-COVID-19 condition.

METHODS

A cross-sectional study was conducted from January to May 2022. The self-assessment survey consisted of the GR-eHEALS, health status- and internet use-related variables, sociodemographic data, and (post)-COVID-19-related medical data. Confirmatory factor analysis (CFA), correlational analyses, and tests of measurement invariance were deployed.

RESULTS

In total, 330 participants were included in the statistical analyses. CFA revealed that the 2-factor model reached an excellent model fit (comparative fit index=1.00, Tucker-Lewis index=0.99, root mean square error of approximation=0.036, standardized root mean square residual=0.038). Convergent validity was confirmed by significant positive correlations between eHL and knowledge of internet-based health promotion programs, experience in using these programs, and the duration of private internet use. In addition, a significantly negative relationship of eHL with internet anxiety supported convergent validity. Further, significant relationships of eHL with mental health status and internal health locus of control confirmed the criterion validity of the instrument. However, relationships of eHL with physical health status and quality of life could not be confirmed. The 2-factor model was fully measurement invariant regarding gender. Regarding age and educational level, partial measurement invariance was confirmed. The subscales as well as the overall GR-eHEALS reached good-to-excellent reliability (Cronbach α≥.86).

CONCLUSIONS

The GR-eHEALS is a reliable and largely valid instrument for assessing eHL in individuals with the post-COVID-19 condition. Measurement invariance regarding gender was fully confirmed and allows the interpretation of group differences. Regarding age and educational level, group differences should be interpreted with caution. Given the high likelihood that individuals with the post-COVID-19 condition will be confronted with misinformation on the Internet, eHL is a core competency that is highly relevant in this context, in both research and clinical practice. Therefore, future research should also explore alternative instruments to capture eHL to overcome shortcomings in the validity of the GR-eHEALS.

The coronavirus disease 2019 infodemic: a concept analysis

Aim

This study aimed to analyze the coronavirus disease 2019 (COVID-19) infodemic phenomenon in the medical field, providing essential data to help healthcare professionals understand it.

Methods

This study utilized a hybrid model for concept analysis. In the theoretical phase (first phase), a literature review was conducted using ScienceDirect, PubMed, CINAHL, ProQuest, Scopus, Web of Science, DBpia, RISS, and KISS. Semi-structured interviews, involving eight physicians and six nurses, were used in the fieldwork phase (second phase). In the final analysis phase (third phase), the results of the preceding phases were combined.

Results

Based on the findings of these phases, the COVID-19 infodemic can be defined as "the phenomenon of information flood, reproduction, dissemination, and asymmetry, which occurred during the pandemic through social networks among the public lacking essential knowledge of infectious disease, and is associated with negative and positive effects."

Conclusion

Our findings can help the Ministry of Health and Welfare and healthcare professionals to understand the phenomenon of the infodemic and prepare necessary strategies and education programs for the public. Therefore, the provision of basic data is important for developing influential roles for healthcare professionals during infectious disease outbreaks.

Scenario-based assessment of emergency management of urban infectious disease outbreaks

Infectious diseases pose a severe threat to human health and are accompanied by significant economic losses. Studies of urban outbreaks of infectious diseases are diverse. However, previous studies have neglected the identification of critical events and the evaluation of scenario-based modeling of urban infectious disease outbreak emergency management mechanisms. In this paper, we aim to conduct an empirical analysis and scenario extrapolation using a questionnaire survey of 18 experts, based on the CIA-ISM method and scenario theory, to identify the key factors influencing urban infectious disease outbreaks. Subsequently, we evaluate the effectiveness of urban infectious disease outbreak emergency management mechanisms. Finally, we compare and verify the actual situation of COVID-19 in China, drawing the following conclusions and recommendations. (1) The scenario-based urban infectious disease emergency management model can effectively replicate the development of urban infectious diseases. (2) The establishment of an emergency command center and the isolation and observation of individuals exposed to infectious diseases are crucial factors in the emergency management of urban outbreaks of infectious disease.

Facilitators and barriers to vaccination uptake in pregnancy: A qualitative systematic review

INTRODUCTION

Vaccination during pregnancy protects both the mother and the foetus from vaccine-preventable diseases. However, uptake of the recommended vaccines (influenza, pertussis, COVID-19) by pregnant women remains low in Europe and the USA. Understanding the reasons for this is crucial to inform strategies to increase vaccination rates in pregnant women. This qualitative systematic review aimed to identify the barriers and facilitators to vaccination against influenza, pertussis/whooping cough and COVID-19 during pregnancy and identify possible strategies to increase vaccination rates.

METHODS

We conducted a comprehensive search of electronic databases, including Medline, PsycINFO, CINAHL, Web of Science, WHO database, Embase and grey literature to identify qualitative studies that explored barriers and facilitators to vaccine uptake among pregnant women (PROSPERO CRD42023399488). The search was limited to studies published between 2012 and 2022 conducted in high-income countries with established vaccination programmes during pregnancy. Studies were thematically analysed and underwent quality assessment using the Joanna Briggs Institute validated critical appraisal tool for qualitative research.

RESULTS

Out of 2681 articles screened, 28 studies (n = 1573 participants) were eligible for inclusion. Five overarching themes emerged relating to personal, provider and systemic factors. Barriers to vaccine uptake included concerns about vaccine safety and efficacy, lack of knowledge about vaccines' benefits and necessity, fear of adverse effects on the foetus or mother and low perception of disease severity. Facilitators included recommendations from trusted healthcare providers, easy access to vaccination, clear communication on the benefits and safety of vaccination, and positive social influences from family and friends. Strategies for increasing vaccination uptake included strong and proactive vaccine recommendations by trusted healthcare professionals, provision of vaccines during routine antenatal care, and clear and consistent communication about vaccines addressing pregnant women's concerns.

CONCLUSION

This review highlights the need for interventions that address the identified barriers to vaccine uptake among pregnant women. Recommendation from a healthcare provider can play a significant role in promoting vaccine uptake, as can clear risk/benefit communication and convenient access to vaccination. Addressing concerns about vaccine safety and providing accurate information about vaccines is also important.

The role of the (in)accessibility of social media data for infodemic management: a public health perspective on the situation in the European Union in March 2024

Public health institutions rely on the access to social media data to better understand the dynamics and impact of infodemics - an overabundance of information during a disease outbreak, potentially including mis-and disinformation. The scope of the COVID-19 infodemic has led to growing concern in the public health community. The spread of harmful information or information voids may negatively impact public health. In this context, social media are of particular relevance as an integral part of our society, where much information is consumed. In this perspective paper, we discuss the current state of (in)accessibility of social media data of the main platforms in the European Union. The European Union's relatively new Digital Services Act introduces the obligation for platforms to provide data access to a wide range of researchers, likely including researchers at public health institutions without formal academic affiliation. We examined eight platforms (Facebook, Instagram, LinkedIn, Pinterest, Snapchat, TikTok, X, YouTube) affected by the new legislation in regard to data accessibility. We found that all platforms apart from TikTok offer data access through the Digital Services Act. Potentially, this presents a fundamentally new situation for research, as before the Digital Services Act, few platforms granted data access or only to very selective groups of researchers. The access regime under the Digital Services Act is, however, still evolving. Specifics such as the application procedure for researcher access are still being worked out and results can be expected in spring 2024. The impact of the Digital Services Act on research will therefore only become fully apparent in the future.

Sourcing UK COVID-19 News: An Analysis of Sourcing Patterns of 15 UK News Outlets Reporting on COVID-19 Across Facebook, Twitter, and Instagram

How a health emergency is defined and presented through the news media matters for public understanding and health outcomes. Previous studies have endeavored to identify the patterns of news sourcing in crisis coverage, specifically the interplay between political sources and health expert sources, but yielded inconclusive results. This study analyses the types and roles of actors (those entities mentioned in a story) and sources cited in news coverage of COVID-19 by surveying social media posts published by 15 UK news outlets coverage across Facebook, Twitter, and Instagram between 1 January to December 31 2020. Overall, the findings show the prominence of political sources in UK news and that the most frequently named sources were representatives of the UK government. Moreover, when stories involved political actors, they were more likely to be given a voice as a source. This demonstrates how COVID-19 was a generalized crisis for the UK, which cascaded beyond health and into other economic, social, and cultural domains. The data show some variations in sourcing patterns between the different social media platforms. The analysis suggests that this may reflect the conventions of presenting news on each platform, with some tending toward the model of consensus by prioritizing political and government sources, and others contributing to a sphere of legitimate controversy by giving voice to a wider range of sources. This is distinctive and opens up the possibility for further research on how journalists adapt stories for social media and the consequences for public health communication.

YouTube vloggers set the stage: How public (non)compliance with COVID-19 regulations affects adolescents

INTRODUCTION

YouTube vloggers may be important socialization figures, yet their influence on adolescents' health-related behaviors and cognitions is largely untested. In this two-study mixed-method project, we first assessed the extent of (non)compliance to COVID-19 regulations by vloggers on YouTube and how viewers reacted to this. Second, we experimentally assessed the effects of vlogger behavior paired with viewer evaluations on adolescents' COVID-19-related attitudes, intentions, and behavior.

METHODS

For Study 1, we coded 240 vlogs of eight popular Dutch vloggers on YouTube recorded in the period of February 2020-March 2021. For our 2 × 2 between-subjects experiment in Study 2, Dutch adolescents (N = 285, Mage = 12.99, SD = 1.02, 41.8% girls) were randomly assigned to conditions in which they saw vlogs showing either compliance or noncompliance to COVID-19 regulations, and to conditions in which they saw either supportive or dismissive comments under these vlogs.

RESULTS

Study 1: Vloggers' noncompliance with COVID-19 regulations was not uncommon and received relatively more viewer support than compliance, suggesting that portrayed noncompliance may be potentially influential. Study 2: Adolescents were more worried about COVID-19 after they watched a compliant (vs. noncompliant) vlogger. Also, vlogger noncompliance decreased adolescents' perceived importance of COVID-19 regulations and rule-setting for adolescents who identified strongly with the vloggers they watched.

CONCLUSIONS

Vloggers' (non)compliance affects adolescents' COVID-19-related worrying, and attitudes and behavior of adolescents who identify with vloggers strongly. This seems concerning given the sometimes harmful and risky behaviors vloggers portray online but could potentially also be employed to encourage healthy behaviors.

Investigating Beliefs in Anti-Vax Conspiracy Theories among Medical Students

While the doctors' role in immunization is essential, their lack of knowledge or vaccine hesitancy may affect their ability to communicate effectively and educate patients about vaccination, vaccine hesitancy, and vaccine conspiracy theories. This, in turn, may hinder health policy aimed at fighting infectious diseases. Vaccine hesitancy is prevalent not only among the general population but also among healthcare workers; thus, this study is aimed at assessing future doctors' attitudes towards anti-vax conspiracy theories. A total of 441 medical students at Poznan University of Medical Sciences completed a web-based survey designed to explore their attitudes toward the six most prevalent anti-vaccine conspiracy theories. The survey showed that although over 97% of future doctors support vaccinations as an effective form of fighting infectious diseases, and 80% did not believe in any anti-vax conspiracy theory, a significant fraction of 20% of medical students either believed in at least one such theory or were unsure. It has also shown that male and younger students who had not received a flu vaccination and defined themselves as politically right-wing or conservative and religious were more likely to believe in anti-vax conspiracy theories. Our data suggest that, in order to overcome medical students' ambivalent attitudes towards anti-vax conspiracy theories, they should receive more education about the importance of vaccination in preventing disease and about effective ways to combat vaccine hesitancy and anti-vax conspiracy theories.

A Snapshot of COVID-19 Vaccine Discourse Related to Ethnic Minority Communities in the United Kingdom Between January and April 2022: Mixed Methods Analysis

BACKGROUND

Existing literature highlights the role of social media as a key source of information for the public during the COVID-19 pandemic and its influence on vaccination attempts. Yet there is little research exploring its role in the public discourse specifically among ethnic minority communities, who have the highest rates of vaccine hesitancy (delay or refusal of vaccination despite availability of services).

OBJECTIVE

This study aims to understand the discourse related to minority communities on social media platforms Twitter and YouTube.

METHODS

Social media data from the United Kingdom was extracted from Twitter and YouTube using the software Netlytics and YouTube Data Tools to provide a "snapshot" of the discourse between January and April 2022. A mixed method approach was used where qualitative data were contextualized into codes. Network analysis was applied to provide insight into the most frequent and weighted keywords and topics of conversations.

RESULTS

A total of 260 tweets and 156 comments from 4 YouTube videos were included in our analysis. Our data suggests that the most popular topics of conversation during the period sampled were related to communication strategies adopted during the booster vaccine rollout. These were noted to be divisive in nature and linked to wider conversations around racism and historical mistrust toward institutions.

CONCLUSIONS

Our study suggests a shift in narrative from concerns about the COVID-19 vaccine itself, toward the strategies used in vaccination implementation, in particular the targeting of ethnic minority groups through vaccination campaigns. The implications for public health communication during crisis management in a pandemic context include acknowledging wider experiences of discrimination when addressing ethnic minority communities.

Factors influencing public participation behavior relating to government microblogs on COVID-19 updates

Introduction

During the global COVID-19 pandemic, densely populated megacities engaged in active international exchanges have faced the most severe impacts from both the disease and the associated infodemic. This study examines the factors influencing public participation behavior on government microblogs in these megacities during the pandemic. It guides megacities in disseminating epidemic information, promoting knowledge on epidemic prevention, managing public opinion, and addressing related matters.

Methods

Utilizing the elaboration likelihood model's central and peripheral routes, drawing on an empirical analysis of 6,677 epidemic-related microblogs from seven Chinese megacities, this study analyses the influence mechanisms influencing public participation behavior and reveals the regulatory role of confirmed case numbers. Meanwhile,a qualitative comparative analysis examines and discusses diferent confgurations of ixn fuential factors.

Results

The study reveals that microblog content richness demonstrates a U-shaped impact on public participation behavior. Conversely, content interaction, content length, and the number of fans positively impact participation, while update frequency has a negative impact. Additionally, the number of new confrmed cases positively regulates the impact of microblog content and publisher characteristics on public participation behavior. Public participation behavior also varies based on publishing time and content semantic features. This study further revealed the different confgurations of influential factors by QCA method.

Conclusion

This study reveals the impact mechanism of the microblog content and publisher characteristics on public participation behavior. It also demonstrates the regulatory role of newly confrmed cases in the way content and publishers' characteristics influence public participation behavior. This study is of great significance for the operation of government microblogs, the release of emergency information, and the promotion of public participation.

The Misinformation Susceptibility Test (MIST): A psychometrically validated measure of news veracity discernment

Interest in the psychology of misinformation has exploded in recent years. Despite ample research, to date there is no validated framework to measure misinformation susceptibility. Therefore, we introduce Verification done, a nuanced interpretation schema and assessment tool that simultaneously considers Veracity discernment, and its distinct, measurable abilities (real/fake news detection), and biases (distrust/naïvité-negative/positive judgment bias). We then conduct three studies with seven independent samples (Ntotal = 8504) to show how to develop, validate, and apply the Misinformation Susceptibility Test (MIST). In Study 1 (N = 409) we use a neural network language model to generate items, and use three psychometric methods-factor analysis, item response theory, and exploratory graph analysis-to create the MIST-20 (20 items; completion time < 2 minutes), the MIST-16 (16 items; < 2 minutes), and the MIST-8 (8 items; < 1 minute). In Study 2 (N = 7674) we confirm the internal and predictive validity of the MIST in five national quota samples (US, UK), across 2 years, from three different sampling platforms-Respondi, CloudResearch, and Prolific. We also explore the MIST's nomological net and generate age-, region-, and country-specific norm tables. In Study 3 (N = 421) we demonstrate how the MIST-in conjunction with Verification done-can provide novel insights on existing psychological interventions, thereby advancing theory development. Finally, we outline the versatile implementations of the MIST as a screening tool, covariate, and intervention evaluation framework. As all methods are transparently reported and detailed, this work will allow other researchers to create similar scales or adapt them for any population of interest.

[Mis- and disinformation in social media: mitigating risks in digital health communication]

Misinformation and disinformation in social media have become a challenge for effective public health measures. Here, we examine factors that influence believing and sharing false information, both misinformation and disinformation, at individual, social, and contextual levels and discuss intervention possibilities.At the individual level, knowledge deficits, lack of skills, and emotional motivation have been associated with believing in false information. Lower health literacy, a conspiracy mindset and certain beliefs increase susceptibility to false information. At the social level, the credibility of information sources and social norms influence the sharing of false information. At the contextual level, emotions and the repetition of messages affect belief in and sharing of false information.Interventions at the individual level involve measures to improve knowledge and skills. At the social level, addressing social processes and social norms can reduce the sharing of false information. At the contextual level, regulatory approaches involving social networks is considered an important point of intervention.Social inequalities play an important role in the exposure to and processing of misinformation. It remains unclear to which degree the susceptibility to belief in and share misinformation is an individual characteristic and/or context dependent. Complex interventions are required that should take into account multiple influencing factors.

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

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

Misinformation on resuscitation and first aid as an uncontrolled problem that demands close attention: a brief scoping review

OBJECTIVES

Misinformation is currently recognised by the World Health Organization as an apparent threat to public health. This study aimed to provide an outline of published evidence on misinformation related to the potentially life-saving interventions - first aid and cardiopulmonary resuscitation (CPR).

STUDY DESIGN

A scoping review.

METHODS

The review was conducted in accordance with the PRISMA Extension for Scoping Reviews. English-language publications describing original studies that evaluated the quality of publicly available information on first aid and/or CPR were included without limitations to the year of publication.

RESULTS

Forty-four original studies published between 1982 and 2023 were reviewed. Annual number of publications varied from 0 to 6. The studies have focused on the evaluation of information concerning initial care of cardiac arrest, choking, heart attack, poisoning, burns, and other emergencies. Forty three studies (97.7 %) have reported varying frequencies of misinformation, when public sources, including websites, YouTube videos, and modern artificial intelligence-based chatbots, omitted life-saving instructions on first aid or CPR or contained incorrect information that contradicted relevant international guidelines. Eleven studies (25.0 %) have also revealed potentially harmful advice, which, if followed by an unsuspecting person, may cause direct injury or death of a victim.

CONCLUSIONS

Misinformation concerning CPR and first aid cannot be ignored and demands close attention from relevant stakeholders to mitigate its harmful impacts. More studies are urgently needed to determine optimal methods for detecting and measuring misinformation, to understand mechanisms that drive its spread, and to develop effective measures to correct and prevent misinformation.

Path analysis of perceived disease vulnerability, COVID-19 fear, and lower vaccine hesitancy within the context of protection motivation theory

COVID-19 vaccinations have demonstrated effectiveness in reducing severe infections. However, vaccine hesitancy posed a major public health hurdle to combat the COVID-19 pandemic. Online spread of vaccine conspiracy beliefs generated unwarranted mistrust and resistance to vaccines. While numerous studies have explored the factors influencing vaccine hesitancy, there remains a lack of comprehensive understanding regarding the interplay between perceived disease vulnerability, COVID-19 fear, and vaccine hesitancy. Protection motivation theory posits citizens will evaluate perceived threats and take actions to mitigate potential harm. With a large U.S. sample, path analysis demonstrated individuals' perceived disease vulnerability was associated with lower vaccine hesitancy. Greater perceived disease vulnerability was associated with higher COVID-19 fear. Greater COVID-19 fear was associated with lower vaccine hesitancy. Greater vaccine conspiracy beliefs associated with higher vaccine hesitancy. However, in the presence of perceived vulnerability to disease, vaccine conspiracy beliefs associated with higher fear of COVID-19 and thereby lower vaccine hesitancy. We found under circumstances of higher perceived vulnerability to disease and fear of COVID-19, vaccine conspiratorial believers were less vaccine hesitant. We discuss how public health messaging can highlight personal risks to contracting COVID-19 to appeal to those who self-identify as disease prone, but may have reservations about vaccines because of misinformation. Successfully combating diseases entails reaching and gaining cooperation from misbelievers because misinformation is expected to continue in the digital age. By understand individual differences to vaccine hesitancy, it can help increase vaccinations and prevent severe illnesses in the post COVID-19 pandemic era.

Survival analysis of the duration of rumors during the COVID-19 pandemic

BACKGROUND

The emergence of the COVID-19 pandemic towards the end of 2019 triggered a relentless spread of online misinformation, which significantly impacted societal stability, public perception, and the effectiveness of measures to prevent and control the epidemic. Understanding the complex dynamics and characteristics that determine the duration of rumors is crucial for their effective management. In response to this urgent requirement, our study takes survival analysis method to analyze COVID-19 rumors comprehensively and rigorously. Our primary aim is to clarify the distribution patterns and key determinants of their persistence. Through this exploration, we aim to contribute to the development of robust rumor management strategies, thereby reducing the adverse effects of misinformation during the ongoing pandemic.

METHODS

The dataset utilized in this research was sourced from Tencent's "Jiao Zhen" Verification Platform's "Real-Time Debunking of Novel Coronavirus Pneumonia" system. We gathered a total of 754 instances of rumors from January 18, 2020, to January 17, 2023. The duration of each rumor was ascertained using the Baidu search engine. To analyze these rumors, survival analysis techniques were applied. The study focused on examining various factors that might influence the rumors' longevity, including the theme of the content, emotional appeal, the credibility of the source, and the mode of presentation.

RESULTS

Our study's results indicate that a rumor's lifecycle post-emergence typically progresses through three distinct phases: an initial rapid decline phase (0-25 days), followed by a stable phase (25-1000 days), and ultimately, an extinction phase (beyond 1000 days). It is observed that half of the rumors fade within the first 25 days, with an average duration of approximately 260.15 days. When compared to the baseline category of prevention and treatment rumors, the risk of dissipation is markedly higher in other categories: policy measures rumors are 3.58 times more likely to perish, virus information rumors have a 0.52 times higher risk, epidemic situation rumors are 4.86 times more likely to die out, and social current affairs rumors face a 2.02 times increased risk. Additionally, in comparison to wish rumors, bogie rumors and aggression rumors have 0.26 and 0.27 times higher risks of dying, respectively. In terms of presentation, graphical and video rumors share similar dissolution risks, whereas textual rumors tend to have a longer survival time. Interestingly, the credibility of the rumor's source does not significantly impact its longevity.

CONCLUSION

The survival time of rumors is strongly linked to their content theme and emotional appeal, whereas the credibility of the source and the format of presentation have a more auxiliary influence. This study recommends that government agencies should adopt specific strategies to counter rumors. Experts and scholars are encouraged to take an active role in spreading health knowledge. It's important for the public to proactively seek trustworthy sources for accurate information. Media platforms are advised to maintain journalistic integrity, verify the accuracy of information, and guide the public towards improved media literacy. These actions, collectively, can foster a collaborative alliance between the government and the media, effectively combating misinformation.

Fake news research trends, linkages to generative artificial intelligence and sustainable development goals

In the digital age, where information is a cornerstone for decision-making, social media's not-so-regulated environment has intensified the prevalence of fake news, with significant implications for both individuals and societies. This study employs a bibliometric analysis of a large corpus of 9678 publications spanning 2013-2022 to scrutinize the evolution of fake news research, identifying leading authors, institutions, and nations. Three thematic clusters emerge: Disinformation in social media, COVID-19-induced infodemics, and techno-scientific advancements in auto-detection. This work introduces three novel contributions: 1) a pioneering mapping of fake news research to Sustainable Development Goals (SDGs), indicating its influence on areas like health (SDG 3), peace (SDG 16), and industry (SDG 9); 2) the utilization of Prominence percentile metrics to discern critical and economically prioritized research areas, such as misinformation and object detection in deep learning; and 3) an evaluation of generative AI's role in the propagation and realism of fake news, raising pressing ethical concerns. These contributions collectively provide a comprehensive overview of the current state and future trajectories of fake news research, offering valuable insights for academia, policymakers, and industry.

Public and commercial more of the same? The characteristics of the opening monologues of public and commercial channels during the COVID-19 pandemic

The novel coronavirus, COVID-19, first identified in Wuhan, China, in December 2019, rapidly spread across the globe and resulted in significant public concern. In response, numerous countries have implemented guidelines aimed at promoting social distancing, limiting movement and gatherings, instituting lockdowns and curfews, and closing institutions. As a result, the media, including news releases, has become a primary source of information for many individuals (Laor & Lissitsa, 2022). The present study seeks to investigate differences between major television programs featured on public and commercial channels in Israel, utilizing the lens of framing theory. Specifically, twelve monologues broadcast simultaneously on both channels were analyzed to compare differences in content, topics, format, and accompanying visuals. The study's results indicate that both commercial and public channels exhibited similar behavior in shaping public opinion during the crisis period. Specifically, both channels displayed criticism of the government's conduct and utilized negative framing techniques while neglecting to provide space for popular voices. Nevertheless, certain distinctions between the commercial and public broadcasting spheres still persist, particularly in the realm of visual presentation, as some long-standing elements that typify each channel have endured over time.

The role of social media literacy in infodemic management: a systematic review

Background

The term infodemic refers to the proliferation of both accurate and inaccurate information that creates a challenge in identifying trustworthy and credible sources. Among the strategies employed to mitigate the impact of the infodemic, social media literacy has emerged as a significant and effective approach. This systematic review examines the role of social media literacy in the management of the infodemic.

Methods

Six databases, including SID, Magiran, Scopus, PubMed, Google Scholar and Web of Science were systematically searched using relevant keywords. We included the relevant publications between 2012 and 2023 in our analysis. To ensure a qualitative assessment of the studies, we used the STROBE and AMSTAR checklists as evaluation tools. The Preferred Reporting Items for Systematic Reviews (PRISMA) guideline was used for the design of this review study. Finally, we organized the studies into groups based on similarities and retrieved and analyzed evidence pertaining to the challenges and opportunities identified.

Results

Eleven papers were included in this study after reviewing the retrieved studies. Five of them examined the effect of social media literacy and health literacy on acceptance of health behaviors. Four studies investigated the role of media literacy in managing misinformation and fake news related to health. Two studies focused on infodemic management and promoting citizen engagement during health crises. Results showed that health-related infodemics are derived from the users' lack of media knowledge, distrust of government service systems, local influencers and peers, rapid circulation of information through mass media messages, weakness of solutions proposed by health care providers, failure to pay attention to the needs of the audience, vertical management, and inconsistency of published messages.

Conclusion

The findings of this study highlight the importance of increasing social media literacy among the general public as a recognized strategy for managing the infodemic. Consequently, it is recommended that relevant organizations and institutions, such as the Ministry of Health, develop targeted training programs to effectively address this need.

Use of immunology in news and YouTube videos in the context of COVID-19: politicisation and information bubbles

Background

The COVID-19 pandemic propelled immunology into global news and social media, resulting in the potential for misinterpreting and misusing complex scientific concepts.

Objective

To study the extent to which immunology is discussed in news articles and YouTube videos in English and Italian, and if related scientific concepts are used to support specific political or ideological narratives in the context of COVID-19.

Methods

In English and Italian we searched the period 11/09/2019 to 11/09/2022 on YouTube, using the software Mozdeh, for videos mentioning COVID-19 and one of nine immunological concepts: antibody-dependent enhancement, anergy, cytokine storm, herd immunity, hygiene hypothesis, immunity debt, original antigenic sin, oxidative stress and viral interference. We repeated this using MediaCloud for news articles.Four samples of 200 articles/videos were obtained from the randomised data gathered and analysed for mentions of concepts, stance on vaccines, masks, lockdown, social distancing, and political signifiers.

Results

Vaccine-negative information was higher in videos than news (8-fold in English, 6-fold in Italian) and higher in Italian than English (4-fold in news, 3-fold in videos). We also observed the existence of information bubbles, where a negative stance towards one intervention was associated with a negative stance to other linked ideas. Some immunological concepts (immunity debt, viral interference, anergy and original antigenic sin) were associated with anti-vaccine or anti-NPI (non-pharmacological intervention) views. Videos in English mentioned politics more frequently than those in Italian and, in all media and languages, politics was more frequently mentioned in anti-guidelines and anti-vaccine media by a factor of 3 in video and of 3-5 in news.

Conclusion

There is evidence that some immunological concepts are used to provide credibility to specific narratives and ideological views. The existence of information bubbles supports the concept of the "rabbit hole" effect, where interest in unconventional views/media leads to ever more extreme algorithmic recommendations.

Cross-platform social dynamics: an analysis of ChatGPT and COVID-19 vaccine conversations

The role of social media in information dissemination and agenda-setting has significantly expanded in recent years. By offering real-time interactions, online platforms have become invaluable tools for studying societal responses to significant events as they unfold. However, online reactions to external developments are influenced by various factors, including the nature of the event and the online environment. This study examines the dynamics of public discourse on digital platforms to shed light on this issue. We analyzed over 12 million posts and news articles related to two significant events: the release of ChatGPT in 2022 and the global discussions about COVID-19 vaccines in 2021. Data was collected from multiple platforms, including Twitter, Facebook, Instagram, Reddit, YouTube, and GDELT. We employed topic modeling techniques to uncover the distinct thematic emphases on each platform, which reflect their specific features and target audiences. Additionally, sentiment analysis revealed various public perceptions regarding the topics studied. Lastly, we compared the evolution of engagement across platforms, unveiling unique patterns for the same topic. Notably, discussions about COVID-19 vaccines spread more rapidly due to the immediacy of the subject, while discussions about ChatGPT, despite its technological importance, propagated more gradually.

#HealthyLifestyle: A Q methodology analysis of why young adults like to use social media to access health information

Social media has become an integral part of modern society. Many people now turn to social media platforms to share or gain knowledge about best practices for personal health. This new form of health information dissemination has greatly increased in popularity especially among young adults. Currently, more research is needed to identify why so many individuals choose to turn to social media for health information. Using Q methodology, this study aimed to uncover the attitudes, opinions, and beliefs of young adults who engage with social media as a means of obtaining health and fitness information. Results revealed four primary factors: the Health Connoisseurs, the Health Enthusiasts, the Loyalists, and the Virtual Befrienders. Each group possessed different motivations for accessing health-related content on social media. The insights gained from this study can benefit public health institutions, advertisers, and social media content creators as they disseminate health information on social media platforms.

Modelling and predicting online vaccination views using bow-tie decomposition

Social media has become increasingly important in shaping public vaccination views, especially since the COVID-19 outbreak. This paper uses bow-tie structure to analyse a temporal dataset of directed online social networks that represent the information exchange among anti-vaccination, pro-vaccination and neutral Facebook pages. Bow-tie structure decomposes a network into seven components, with two components, strongly connected component (SCC) and out-periphery component (OUT), emphasized in this paper: SCC is the largest strongly connected component, acting as an 'information magnifier', and OUT contains all nodes with a directed path from a node in SCC, acting as an 'information creator'. We consistently observe statistically significant bow-tie structures with different dominant components for each vaccination group over time. In particular, the anti-vaccination group has a large OUT, and the pro-vaccination group has a large SCC. We further investigate changes in opinions over time, as measured by fan count variations, using agent-based simulations and machine learning models. Across both methods, accounting for bow-tie decomposition better reflects information flow differences among vaccination groups and improves our opinion dynamics prediction results. The modelling frameworks we consider can be applied to any multi-stance temporal network and could form a basis for exploring opinion dynamics using bow-tie structure in a wide range of applications.

'It's quite a balancing act': A qualitative study of parents' experiences and information needs related to the COVID-19 pandemic

INTRODUCTION

Throughout the coronavirus disease 2019 (COVID-19) pandemic, parents and children faced significant challenges as a result of prevention measures implemented to control the spread of the disease. Ensuring that families have access to essential health information is critical for improving health outcomes and adherence to public health recommendations. Understanding parents' experiences and information needs related to the pandemic and associated health measures (e.g., vaccination, mask wearing, social distancing, etc.) will inform the development and dissemination of resources tailored to parents' needs to support informed decision making.

METHODS

We conducted a qualitative descriptive study. Between September and November 2021, parents across Canada were recruited online via social media and community organisation newsletters and listservs to participate in focus groups via Zoom. Focus groups were audio-recorded and transcribed verbatim. Data were coded and analysed using thematic analysis. Participants completed a demographic questionnaire before the focus groups (via SimpleSurveys).

RESULTS

Sixty-seven parents participated in 12 focus groups between October and November 2021. In relation to experiences, parents felt they were (1) constantly trying to balance everything, and (2) trying to do their best with the information they had at the time when making decisions. Regarding information needs, parents reflected on (1) how difficult it was navigating copious amounts of changing information and finding credible sources to rely on, (2) the need for resources that were easily accessible, credible and in plain language and (3) the need for resources that were tailored to their needs to support them and their children make informed decisions.

CONCLUSIONS

Trying to mitigate the risk of COVID-19 infection and adhere to public health recommendations, while balancing various factors (work, online learning, and social interactions) and navigating changing information, was overwhelming for many parents. Reflecting on their needs, parents suggested tailored resources that provided concise, credible information in plain language to help them make informed decisions and navigate conflicting information. These findings reveal important knowledge gaps and highlight areas that need to be addressed to support parents during the pandemic period and beyond.

PATIENT OR PUBLIC CONTRIBUTION

Members of our established Paediatric Parent Advisory Group (P-PAG) were involved as collaborators throughout the planning (grant proposal), development and execution of the study. P-PAG members gave input on the design of the questionnaire, interview guide, recruitment strategy and interpretation of findings.

COVID-19 Event Extraction from Twitter via Extractive Question Answering with Continuous Prompts

As COVID-19 ravages the world, social media analytics could augment traditional surveys in assessing how the pandemic evolves and capturing consumer chatter that could help healthcare agencies in addressing it. This typically involves mining disclosure events that mention testing positive for the disease or discussions surrounding perceptions and beliefs in preventative or treatment options. The 2020 shared task on COVID-19 event extraction (conducted as part of the W-NUT workshop during the EMNLP conference) introduced a new Twitter dataset for benchmarking event extraction from COVID-19 tweets. In this paper, we cast the problem of event extraction as extractive question answering using recent advances in continuous prompting in language models. On the shared task test dataset, our approach leads to over 5% absolute micro-averaged F1-score improvement over prior best results, across all COVID-19 event slots. Our ablation study shows that continuous prompts have a major impact on the eventual performance.

Low credibility URL sharing on Twitter during reporting linking rare blood clots with the Oxford/AstraZeneca COVID-19 vaccine

The COVID-19 pandemic was accompanied by an "infodemic" of misinformation. Misleading narratives around the virus, its origin, and treatments have had serious implications for public health. In March 2021, concerns were raised about links between the Oxford/AstraZeneca (AZ) COVID-19 vaccine and recipients developing blood clots. This paper aims to identify whether this prompted any reaction in the diffusion of low-credibility COVID-19-relate information on Twitter. Twitter's application programming interface was used to collect data containing COVID-19-related keywords between 4th and 25th March 2021, a period centred on the peak of new coverage linking rare blood clots with the AZ vaccine. We analysed and visualised the data using temporal analysis and social network analysis tools. We subsequently analysed the data to determine the most influential users and domains in the propagation of low-credibility information about COVID-19 and the AZ vaccine. This research presents evidence that the peak of news coverage linking rare blood clots with the AZ vaccine correlated with an increased volume and proportion of low-credibility AZ-related content propagated on Twitter. However, no equivalent changes to the volume, propagation, or network structure for the full dataset of COVID-19-related information or misinformation were observed. The research identified RT.com as the most prolific creator of low-credibility COVID-19-related content. It also highlighted the crucial role of self-promotion in the successful propagation of low-credibility content on Twitter. The findings suggest that the simple approach adopted within the research to identify the most popular and influential sources of low-credibility content presents a valuable opportunity for public health authorities and social media platforms to develop bespoke strategies to counter the propagation of misinformation in the aftermath of a breaking news event.

Factors associated with the use of medicines and self-medication during the COVID-19 pandemic in 12 Latin American countries

Introduction

The coronavirus disease 2019 (COVID-19) pandemic has triggered a rise in the global phenomenon of self-medication. The use of medicines with unsubstantiated claims of benefit for the prevention and/or treatment of infected people has been widely adopted.

Objective

To determine the factors associated with the use of medicines and self-medication by Latin American populations during the COVID-19 pandemic.

Methods

This analytical cross-sectional study was conducted via an analysis of secondary data collected from 8777 responses from 12 Latin American countries obtained from a survey on the use of medicines and self-medication during the pandemic.

Results

Respondents who reported using Paracetamol, Ibuprofen, or antibiotics (ABx) disclosed this as self-medication in 26.9%, 16.6%, and 9.7% of cases respectively. In our multivariate analysis, significant associations were found between: self-medication by individual choice and the use of Hydroxychloroquine, ABx, or non-steroidal anti-inflammatory drugs (NSAIDs) (p = 0.026, = 0.003, and <0.001 respectively); self-medication on the recommendation of a family member, with ABx, Paracetamol, Ibuprofen, or other NSAIDs (p <0.001, <0.001, <0.001, and <0.001 respectively); and self-medication on the recommendation of another person, with Chloroquine, Hydroxychloroquine, Azithromycin, Penicillin, other ABx, Warfarin, Ivermectin, Paracetamol, Ibuprofen, or other NSAIDs (p <0.001, <0.001, <0.001, = 0.001, <0.001, <0.001, = 0.004, <0.001, <0.001, and <0.001 respectively).

Conclusion

There was a significantly high prevalence of self-medication in our Latin American study population, including the use of medicines not recommended for COVID-19 treatment and/or prevention. The implementation of public health measures aimed at combating the worrying COVID-19 infodemic is essential to prevent this ongoing issue and its associated negative impacts on both current public health and future medication efficacy. This is especially important in the case of ABx due to the threat of a future antimicrobial resistance pandemic.

Predictors of COVID-19 Vaccine Acceptance: The Role of Trust and the Influence of Social Media

The study discusses the predictors of COVID-19 vaccine acceptance in Romania. We implemented a national survey using an online panel (N = 1006), representative for the online population of Romania aged 18 or higher, conducted on 13-26 October, 2020, by the national pollster QUESTIA. Results show a predictive model of people's willingness to take the COVID-19 vaccine, in which trust in the actors and institutions involved in the management of the crisis is the strongest predictor, followed by the belief in toxic or misleading narratives about vaccines and the COVID-19 pandemic, and media consumption patterns. Education is a moderator of the relationship between trust and the willingness to vaccinate. Implications for professionals in the social work fields, as well as for policy-makers are discussed. Results could be used as a starting point for developing recommendations for evidence-based health communication in the context of the COVID-19 vaccination campaign.

Facts do not speak for themselves: Community norms, dialog, and evidentiary practices in discussions of COVID-19 on Reddit

The present study sought to explore the distinct discourse norms and evidentiary practices in discussions of COVID-19 in four subcommunities on Reddit. Qualitative analysis found that communities differed in the degree to which they reinforce and augment Reddit's platform-wide norms for dialog and evidence use. One of the three communities (r/AskTrumpSupporters) differed from the rest by establishing discourse norms for turn-taking between politically opposed users and structuring dialog around authentic questions aimed at understanding alternative points of view. Quantitative analyses revealed that this community significantly differed from the other communities in the proportion of dialogic exchanges and in the use of evidentiary practices (sourcing, source evaluation, and interpretation of evidence). Excerpts of dialog from this community are used to illustrate findings. We conclude with implications for educators interested in preparing youth to critically engage with scientific information they encounter in public discourse.

Sentiment analysis of the COVID-19 vaccine perception

The sharp rise in coronavirus cases in the United States, as well as other countries, is driven by variants such as the Omicron substrain, BA4 and BA5. Keeping up to date with COVID-19 vaccination and wearing masks are essential tools for mitigating the pandemic. Social media plays a vital role in sharing and exchanging information, but it also affects perceptions of social phenomena. In this study, we conducted sentiment analysis and topic modeling to investigate vaccine perception using 338,465 COVID-19 vaccine-related comments collected from January 2020 to May 2021 on Reddit. This study stands apart from prior COVID-related research on social media, particularly on Reddit, as it conducted separate analyses for each COVID vaccine and examines public sentiment with various societal events, including vaccine development progress and government responses to COVID. The findings reveal two notable spikes in the number of comments containing the keyword "vaccine". This suggests that discussions about vaccines tend to increase during times of significant social and political events, indicating that people's attention and interest in the topic are influenced by current events. Understanding the public perception of vaccines and identifying factors influencing vaccine perception could help propose appropriate interventions to promote vaccination.