e-Health Campaigns for Promoting Influenza Vaccination: Examining Effectiveness of Fear Appeal Messages from Different Sources

Message Effectiveness of Fear Appeals in Vaccination Communication Campaigns: A Systematic Review

This systematic review of 54 cross-disciplinary peer-reviewed causal empirical studies helps public health officials, researchers, and healthcare professionals better comprehend the effects of fear appeals in vaccine promotional campaigns on message processing, persuasion, vaccination attitudes, and vaccination intentions. This review documents inconsistent findings across studies, which it attempts to clarify by considering differences in research designs, sample populations, and outcomes measured. In general, we find that fear appeals increase risk perceptions, message involvement, and vaccination attitudes. However, fear appeals have less influence on vaccination intentions, especially among female and general adult populations or populations from the U.S. and other Western cultures. On the other hand, the effect of fear appeals on vaccination intentions is stronger among student populations and those from China (People's Republic of China and Hong Kong) and other non-Western cultures. Also, fear appeals are less persuasive when promoting COVID-19 vaccines and boosters than they are for other vaccines (e.g., HPV, influenza, MMR). Future research should compare fear appeal effectiveness in messages across vaccines or when combined with other executional elements, such as the endorser or type of evidence provided. Finally, future studies should explore other methodological approaches and measure underexplored message outcomes, such as vaccine uptake behavior, in more naturalistic settings.

Algorithm as Recommending Source and Persuasive Health Communication: Effects of Source Cues, Language Intensity, and Perceived Issue Involvement

Algorithms are now playing significant roles in online health information selection and recommendation. A question arises as to when and why people would be persuaded by the content they recommend. We conducted a 4 (recommending source: algorithm, other users, a friend, the CDC) x 2 (language intensity: high vs. low) experiment to find out. Participants (N = 299) were exposed to a health-related public service announcement embedded in a social media post. The results showed that overall, an algorithm induced a similar level of compliance intention compared with other recommending sources. We also found a significant three-way interaction when comparing the effects of the algorithm and the CDC: for individuals with low issue involvement, the algorithm was less persuasive when paired with a message with high language intensity. In contrast, for high-involvement individuals, the algorithm elicited more fear than the CDC when recommending an assertive message, partially leading to more compliance intention.

Promoting HPV vaccination on social media: interactive effects of threat, efficacy and social cues

BACKGROUND

Women are currently facing a tremendous threat of cervical cancer globally. Social media health campaigns have the potential to shape public health behaviors. This study explores the effects of cervical-cancer-related fear appeal messages with social cues on social media using the extended parallel processing model (EPPM).

METHOD

We use a 2 (threat: present vs. absent) × 2 (efficacy: present vs. absent) × 2 (social cues: high vs. low) factorial experimental design to examine the effects of fear appeal messages with social cues on behavioral intention to receive the human papillomavirus (HPV) vaccination.

RESULTS

There was a significant main effect of threat on the intention to receive HPV vaccination. Additionally, a significant three-way interactive effect among threat, efficacy, and social cues was detected.

CONCLUSION

Women exposed to threat messages had a higher intention of HPV vaccination compared to those who were exposed to non-threat messages. Furthermore, with the low number of likes, women who were exposed to messages containing both threat and efficacy tended to have the highest intention of HPV vaccination.

PRACTICE IMPLICATIONS

When conducting fear appeal campaigns on social media, the side effects of number of likes should be recognized. For vaccination promotion campaigns, the efficacy information should be more specific and audience-centered.

The Use of Digital Technologies to Support Vaccination Programmes in Europe: State of the Art and Best Practices from Experts' Interviews

Digitalisation offers great potential to improve vaccine uptake, supporting the need for effective life-course immunisation services. We conducted semi-structured in-depth interviews with public health experts from 10 Western European countries (Germany, Greece, Italy, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, and the United Kingdom) to assess the current level of digitalisation in immunisation programmes and retrieve data on interventions and best practices. Interviews were performed using an ad hoc questionnaire, piloted on a sample of national experts. We report a mixed level of digital technologies deployment within vaccination services across Europe: Some countries are currently developing eHealth strategies, while others have already put in place robust programmes. Institutional websites, educational videos, and electronic immunisation records are the most frequently adopted digital tools. Webinars and dashboards represent valuable resources to train and support healthcare professionals in immunisation services organisation. Text messages, email-based communication, and smartphone apps use is scattered across Europe. The main reported barrier to the implementation of digital-based programmes is the lack of resources and shared standards. Our study offers a comprehensive picture of the European context and shows the need for robust collaboration between states and international institutions to share best practices and inform the planning of digital intervention models with the aim of countering vaccine hesitancy and increasing vaccine uptake.