Content characteristics driving the diffusion of antismoking messages: implications for cancer prevention in the emerging public communication environment

Effects of Exposure to Conflicting Health Information on Topic-Specific Information Sharing and Seeking Intentions

Despite considerable evidence that exposure to conflicting health information can have undesirable effects on outcomes including public understanding about and trust in health recommendations, comparatively little is known about whether such exposure influences intentions to engage in two communication behaviors central to public health promotion: information sharing and information seeking. The purpose of the current study is to test whether exposure to conflicting information influences intentions to share and seek information about six health topics. We analyzed data from two waves of a longitudinal survey experiment with a nationally representative sample of U.S. adults (N = 3,920). Participants were randomly assigned to either a conflict or no-conflict message condition, in which they read news stories and social media posts about three (of six) randomly selected health topics at Time 1 and the remaining three at Time 2. The dependent variables, which were measured at Time 2, asked participants whether they intended to share or seek information about the three topics they had just viewed. Linear mixed effects models showed that exposure to conflict reduced intentions to share and seek information, regardless of health topic. These findings suggest that exposure to conflicting health information discourages two important types of health information engagement, thus adding to the growing evidence base documenting the adverse consequences of conflicting information for public health.

Belief-consistent information is most shared despite being the least surprising

In the classical information theoretic framework, information "value" is proportional to how novel/surprising the information is. Recent work building on such notions claimed that false news spreads faster than truth online because false news is more novel and therefore surprising. However, another determinant of surprise, semantic meaning (e.g., information's consistency or inconsistency with prior beliefs), should also influence value and sharing. Examining sharing behavior on Twitter, we observed separate relations of novelty and belief consistency with sharing. Though surprise could not be assessed in those studies, belief consistency should relate to less surprise, suggesting the relevance of semantic meaning beyond novelty. In two controlled experiments, belief-consistent (vs. belief-inconsistent) information was shared more despite consistent information being the least surprising. Manipulated novelty did not predict sharing or surprise. Thus, classical information theoretic predictions regarding perceived value and sharing would benefit from considering semantic meaning in contexts where people hold pre-existing beliefs.

Perceived message effectiveness of cigar warning themes among adults in the United States

Most tobacco warnings focus on health harms to the consumer, but other message themes may be promising. We assessed perceived message effectiveness (PME) among adults who smoke cigars for 12 cigar warning statements to discourage smoking, and measured PME across four message themes: explicit health effects to the consumer, secondhand smoke effects, chemicals/constituents, and toxicity. Between April 23 and May 7, 2020, we conducted an online study with U.S. adults who used any cigar type in the past 30 days (n = 777). Participants were randomly assigned to view two out of 12 warnings and rate each one on PME. We analyzed PME mean ratings (range 1 [low] to 5 [high]). The warning statements for lung cancer (M = 3.91) and heart disease (M = 3.77) had the highest PME ratings; secondhand smoke (M = 3.50) and formaldehyde (M = 3.48) had the lowest PME ratings. Multilevel analyses showed that the explicit health effects theme was associated with higher PME ratings compared to other warning themes (ps < 0.05 for chemicals/constituents and secondhand smoke effects) except toxicity (p =.16). Higher awareness of consequences was associated with higher PME ratings (p <.001). Higher nicotine dependence was also associated with higher PME ratings (p = .004). Warning statements with information addressing the themes of health harms and toxicity could potentially inform those who smoke cigars about the broader harms of cigar use and should be considered in FDA labeling regulations for cigars.

Motivation to participate in secondary science communication

The rise of social media provides convenient mechanisms for audiences to participate in secondary science communication (SSC). The present study employs the theory of consumption values and theory of planned behavior to predict audiences' SSC intentions. The results indicate that emotional value, social value, altruistic value, attitude, internal perceived behavioral control and subjective norm are significant predictors of audiences' intentions to share or to repost science content on their social media. These results suggest that the theory of consumption values, together with the theory of planned behavior, is a useful framework for understanding SSC behaviors.

Influence of information attributes on information dissemination in public health emergencies

When public health emergencies occur, relevant information containing different topics, sentiments, and emotions spread rapidly on social media. From the cognitive and emotional dimensions, this paper explores the relationship between information attributes and information dissemination behavior. At the same time, the moderating role of the media factor (user influence) and the time factor (life cycle) in information attributes and information transmission is also discussed. The results confirm differences in the spread of posts under different topic types, sentiment types, and emotion types on social media. At the same time, the study also found that posts published by users with a high number of followers and users of a media type are more likely to spread on social media. In addition, the study also found that posts with different information attributes are easier to spread on social media during the outbreak and recurrence periods. The driving effect of life cycles is more obvious, especially for topics of prayer and fact, negative sentiment, emotions of fear, and anger. Relevant findings have specific contributions to the information governance of public opinion, the development of social media theory, and the maintenance of network order, which can further weaken the negative impact of information epidemic in the occurrence of public health emergencies, maintain normal social order, and thus create favorable conditions for the further promotion of global recovery.

The Antecedents and Consequences of Interpersonal Communication during a School-based Health Intervention

School-based health interventions often have limited and inconsistent effects. Although interpersonal communication likely is important, hardly any studies have investigated interpersonal communication of students with their friends, classmates, and parents about the health programs and health behaviors in school-based health interventions. In a two-wave prospective study of 389 adolescents focusing on three health behaviors (i.e., alcohol use, snack intake, and exercise), we addressed two aims. Our first aim was to investigate how student evaluations of a school-based health intervention influenced interpersonal communication about health behaviors (i.e., valence and frequency of conversations). Findings showed that positively evaluating a school-based health intervention increased how often students talked about the intervention with friends, classmates, and parents, as well as how they discussed the three health behaviors. Our second aim was to investigate the influence of interpersonal communication with friends, classmates, and parents on predictors of health behaviors. We found for conversational frequency that frequently discussing health behaviors resulted in healthier (more positive) predictors of exercise, but also in unhealthier (more positive) predictors of snacking and drinking. Furthermore, findings showed that positively discussing exercising, and negatively discussing snacking and drinking, resulted in healthier predictors of these behaviors. Our findings show that it is important to understand the impact of post-intervention communication and that post-intervention communication with peers and parents about health behaviors are predictors of health behavior.

Understanding the landscape and propagation of COVID-19 misinformation and its correction on Sina Weibo

The prevalence of health misinformation on social media could significantly influence individuals' health behaviors. To examine the prevalent topics, propagation, and correction of coronavirus disease 2019 (COVID-19) misinformation, automated content analyses were conducted for posts on Sina Weibo, which is China's largest microblogging site. In total, 177,816 posts related to COVID-19 misinformation during the COVID-19 outbreak in China were analyzed. The structural topic modeling identified 23 valid topics regarding COVID-19 misinformation and its correction, which were further categorized into three general themes. Sentiment analysis was conducted to generate positive and negative sentiment scores for each post. The zero-inflated Poisson model indicated that only the negative sentiment was a significant predictor of the number of comments (β = 0.003, p < 0.001) but not reposts. Furthermore, users are more prone to repost and comment on information regarding prevention/treatment (e.g., traditional Chinese medicine preventing COVID) as well as potential threats of COVID-19 (e.g., COVID-19 was defined as an epidemic by World Health Organization). Health education and promotion implications are discussed.

The Impact of Retransmission and Modality on Communicating Health Research Findings via Social Media

Social media is an increasingly popular tool for disseminating health research findings to members of the general public and may contribute to improving the effectiveness of science communication. This study was designed to investigate how retransmission (i.e., social media content shared by a familiar, credible organization) and modality (i.e., how the message is delivered) influence the effectiveness of communicating health research findings via social media. The findings from a 2 (source) X 3 (modality) X 2 (topic) mixed factorial design experiment (N= 517) indicated that source had a significant effect, such that posts that were retransmitted by a credible organization resulted in greater perceived source credibility, greater perceived message effectiveness, and greater likelihood of an individual to engage with the post on Facebook. Modality significantly increased perceived source credibility and perceived message effectiveness when posts were retransmitted by a credible source, indicating that modality made a difference when messages were elaborated as a function of the retransmission. Also, the topic of the post had a significant impact on the study's dependent variables of interest. Overall, the findings illustrate the potential of retransmission and modality as message features that can improve communication of health research findings on social media. Theoretical and practical implications are discussed.

The understanding, acceptability, and relevance of personalised multidimensional physical activity feedback among urban adults: evidence from a qualitative feasibility study in Sri Lanka

Background

Wearable technologies are being used to provide personalised feedback across multiple physical activity dimensions in countries such as the UK, but their feasibility has not been tested in South Asia, where physical inactivity is increasing. This study assessed the understanding, acceptability, and relevance of personalised multidimensional physical activity feedback in urban dwellers in Colombo, Sri Lanka.

Methods

A qualitative feasibility study was conducted among 35 adults to assess a community-based approach to provide multidimensional physical activity feedback. Healthy adults, adults at risk of non-communicable diseases and community-based primary healthcare professionals wore a physical activity monitor for 7 days and were then guided through their personalised multidimensional physical activity feedback. One-to-one interviews were conducted, transcribed verbatim and analysed using framework analysis.

Results

Four themes were generated: understanding of personalised physical activity feedback, perceived novelty of the feedback, motivation, and consideration of the multidimensional nature of physical activity. A majority of participants required guidance initially to understand the feedback, following which most were quickly able to interpret the data shown, and were willing to use the feedback as a basis for identifying goals to improve physical activity. Participants perceived the feedback and its delivery as novel because it provided new knowledge about physical activity guidelines and awareness on their own behaviour through graphics. Comparisons of personal performance against recommended physical activity levels and information on sedentary time were the most commonly motivating aspects of the feedback, prompting talk about behaviour change. All three groups showed poor planning on goal achievement, with some noticeable differences between those with and without health risk of non-communicable diseases. Following the feedback, most participants understood that physical activity is composed of several dimensions, while around half could recognise more suitable options to change behaviour. Of the physical activity dimensions, calorie burn received more attention than others.

Conclusions

Multidimensional physical activity feedback was considered understandable and acceptable and has the potential to support behaviour change among urban Sri Lankans with or without identified health risk. These findings highlight the feasibility of this technology-enabled approach as a personalised intervention to improve knowledge and motivation for physical activity behaviour.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10774-0.

How Message Features and Social Endorsements Affect the Longevity of News Sharing

This study examined how message features and social endorsements affect the longevity of audience news sharingby analyzing behavioral data of social retransmission of New York Timeshealth news articles, and associated article content and context data.The results showed that information utility-related message features increased the duration for which articlespromptedemail-based sharing, whereas emotional positivity and controversiality increased the longevity of social media-based sharing. Expressed emotional evocativeness and the absence of death-related words lengthened the duration for which articles prompted both email- and social media-based sharing. Newsretransmission, viaeither email or social media, was more likely to persist when the articles stayed on the "most-emailed" list for a longer time, showingsocial endorsement-driven cumulative advantage effects. The results further revealed synergistic interaction effects between social endorsements and message features. While social endorsements produced strong cumulative-advantage effects on the longevity of news sharing, articles with certain message features that are diagnostic of their inherent share-worthiness generated even stronger effects than those articles that appeared on the "most-emailed" list for the same amount of time but without such features. These features were expressed emotional evocativeness (email-based sharing), the absence of death-related words and exemplification (social media-based sharing).

Effects of Opinion Climate, Efficacy Messages, and Publicness of Social Media on Intentions to Retransmit Anti-Binge Drinking Messages on Facebook

Reducing the rate of college binge drinking is a major public health goal. Social media sites such as Facebook serve as platforms for young adults' online communication, so they could potentially extend the reach of health campaign messages via retransmission. Thus, it is important to identify the factors that predict intentions to share health-related messages on social media. Drawing on the Spiral of Silence framework, the current research examined the effects of opinion climate, message efficacy, and publicness of social media on message retransmission intentions for anti-binge drinking "how-to" messages-messages that include advice and recommendations that target beliefs about efficacy. A 2 × 2 × 2 (efficacy: high vs. low × opinion climate: support vs. oppose × channel: public vs. private) between-subjects experiment was conducted. Data from 245 participants on Amazon Mechanical Turk demonstrated that people were more willing to share when they had an anti- rather than a pro-binge drinking opinion climate, when the messages were more useful, and when they were asked to share via private messaging rather than via public status updates. Theoretical and practical implications for the psychological mechanisms underlying message retransmission on social media are discussed.

To Retweet or Not to Retweet: Understanding What Features of Cardiovascular Tweets Influence Their Retransmission

Twitter is one of the largest social networking sites (SNSs) in the world, yet little is known about what cardiovascular health related tweets go viral and what characteristics are associated with retransmission. The current study aims to identify a function of the observable characteristics of cardiovascular tweets, including characteristics of the source, content, and style that predict the retransmission of these tweets. We identified a random sample of 1,251 tweets associated with CVD originating from the United States between 2009 and 2015. Automated coding was conducted on the affect values of the tweets as well as the presence/absence of any URL, mention of another user, question mark, exclamation mark, and hashtag. We hand-coded the tweets' novelty, utility, theme, and source. The count of retweets was positively predicted by message utility, health organization source, and mention of user handle, but negatively predicted by the presence of URL and nonhealth organization source. Regarding theme, compared to the tweets focusing on risk factor, tweets on treatment and management predicted fewer retweets while supportive tweets predicted more retweets. These findings suggest opportunities for harnessing Twitter to better disseminate cardiovascular educational and supportive information on SNSs.

The Effect of Campaign-Generated Interpersonal Communication on Campaign-Targeted Health Outcomes: A Meta-Analysis

This study examined the effect of mass media campaign-generated conversations on campaign-targeted health outcomes, via a systematic meta-analysis of 28 studies (including 124 sub-studies and a total of 138,898 participants). The study also conducted a series of moderation analyses to examine the conditions under which interpersonal communication has larger effects on bringing about the desired outcomes. The findings of this meta-analysis indicate that campaign-generated conversations have a positive effect on inducing campaign-targeted outcomes (OR = 1.28) and show that this effect is moderated by health topic addressed by the campaign, the type of outcome being targeted by the campaign, and with whom people converse, along with several other campaign-relevant and study-relevant variables. The implications of these findings for future research are discussed.

Why Do Smokers Talk About Antismoking Campaigns? Predictors of the Occurrence and Content of Campaign-Generated Conversations

Smokers often talk about antismoking campaigns, and these conversations can contribute to campaign effectiveness. However, little is known about the predictors and content of naturally occurring campaign-generated conversations. In two studies (Study 1, N = 480; Study 2, N = 232), we systematically examined whether the occurrence and content of smokers' conversations after exposure to one of eight antismoking television advertisements were predicted by characteristics of (a) the message, (b) intrapersonal responses to the message, (c) the individual, and (d) the social context in which exposure occurred. In multivariable models, we found that conversations were more likely to occur when advertisement exposure occurred in the presence of others, and as the amount of anxiety elicited by the advertisement increased. Conversations were more likely to contain a favorable appraisal of the advertisement when the message elicited higher levels of sadness, and less likely to contain favorable appraisals when the respondent had finished secondary education (vs. lower levels of education). Stronger feelings of guilt reduced the likelihood that conversations contained unfavorable appraisals, and increased the likelihood that they contained quitting talk. These findings suggest several promising avenues for future investigations into why smokers talk and talk in particular ways.

Evaluation of emotion-based messages designed to motivate Hispanic and Asian parents of early adolescents to engage in calcium-rich food and beverage parenting practices

BACKGROUND/OBJECTIVES

Setting healthful beverage expectations, making calcium-rich foods and beverages (CRF/B) available, and role modeling are parenting practices promoting calcium intake among early adolescents. This study aimed to evaluate emotion-based messages designed to motivate parents of early adolescents to perform these practices.

SUBJECTS/METHODS

Emotion-based messages were developed for each parenting practice and tested in 35 parents from 5 states. Findings were used to modify messages and develop a survey administered via Amazon MechanicalTurk to a convenience sample of Asian (n = 166) and Hispanic (n = 184) parents of children 10-13 years. Main outcome measures were message comprehension, motivation, relevance, acceptability, and novelty. Engagement in the parenting practices was also assessed.

RESULTS

Message comprehension was acceptable for the majority of parents. Most also agreed that messages were motivational (setting healthful beverage expectations (69.0%), making CRF/B available (67.4%), and role modeling (80.0%)), relevant and acceptable. About 30-50% indicated they had not seen the information before. Many parents indicated they were already engaging in the practices (> 70%). No racial/ethnic differences were observed for responses to messages or engaging in parenting practices.

CONCLUSIONS

Results indicate that emotion-based messages designed to motivate parents to engage in parenting practices that promote calcium intake among early adolescents were motivating, relevant, and acceptable.

Selective Exposure to Health Information: The Role of Headline Features in the Choice of Health Newsletter Articles

This study investigated how content and context features of headlines drive selective exposure when choosing between headlines of a monthly e-mail health newsletter in a naturalistic setting over a period of nine months. Study participants received a monthly e-mail newsletter and could freely open it and click any headline to read the accompanying article. In each e-mail newsletter, nine headlines competed with each other for selection. Textual and visual information of the headlines was content-analyzed, and clickstream data on the headlines were collected automatically. The results showed that headlines invited more frequent audience selections when they provided efficacy-signaling information in an imperative voice, when they used a moderate number of negative emotion words, when they presented negative thumbnail images while mentioning cancer or other diseases, and when they were placed higher in position.

Selection and Transmission Processes for Information in the Emerging Media Environment: Psychological Motives and Message Characteristics

The emerging media environment introduced fundamental changes in the quality and format of information available to the public, which can now flexibly seek, alter, and disseminate the information they receive. Therefore, the two processes of information selection and information retransmission are crucial for understanding the reach of any information available in the online information environment. From this starting point, we examine the common psychological motives driving information selection and transmission of attitude-relevant information: Defense and accuracy motives adding a focus on interpersonal motives. We also review message factors that can activate psychological motives leading to selection of retransmission of information, such as the desire for novelty and emotional stimulation. We speculate about the directions for the next generation of research necessary to understand exposure as a core outcome in media effects research and theory.

Attracting Views and Going Viral: How Message Features and News-Sharing Channels Affect Health News Diffusion

This study examined how intrinsic as well as perceived message features affect the extent to which online health news stories prompt audience selections and social retransmissions, and how news-sharing channels (e-mail vs. social media) shape what goes viral. The study analyzed actual behavioral data on audience viewing and sharing of New York Times health news articles, and associated article content and context data. News articles with high informational utility and positive sentiment invited more frequent selections and retransmissions. Articles were also more frequently selected when they presented controversial, emotionally evocative, and familiar content. Informational utility and novelty had stronger positive associations with e-mail-specific virality, while emotional evocativeness, content familiarity, and exemplification played a larger role in triggering social media-based retransmissions.

The use of social media by state tobacco control programs to promote smoking cessation: a cross-sectional study

BACKGROUND

The promotion of evidence-based cessation services through social media sites may increase their utilization by smokers. Data on social media adoption and use within tobacco control programs (TCPs) have not been reported.

OBJECTIVE

This study examines TCP use of and activity levels on social media, the reach of TCP sites, and the level of engagement with the content on sites.

METHODS

A cross-sectional descriptive study of state TCP social media sites and their content was conducted.

RESULTS

In 2013, 60% (30/50) of TCPs were using social media. Approximately one-quarter (26%, 13/50) of all TCPs used 3 or more social media sites, 24% (12/50) used 2, and 10% (5/50) used 1 site. Overall, 60% (30/50) had a Facebook page, 36% (18/50) had a Twitter page, and 40% (20/50) had a YouTube channel. The reach of social media was different across each site and varied widely by state. Among TCPs with a Facebook page, 73% (22/30) had less than 100 likes per 100,000 adults in the state, and 13% (4/30) had more than 400 likes per 100,000 adults. Among TCPs with a Twitter page, 61% (11/18) had less than 10 followers per 100,000 adults, and just 1 state had more than 100 followers per 100,000 adults. Seven states (23%, 7/30) updated their social media sites daily. The most frequent social media activities focused on the dissemination of information rather than interaction with site users. Social media resources from a national cessation media campaign were promoted infrequently.

CONCLUSIONS

The current reach of state TCP social media sites is low and most TCPs are not promoting existing cessation services or capitalizing on social media's interactive potential. TCPs should create an online environment that increases participation and 2-way communication with smokers to promote free cessation services.