Effects of Narrative Messages on Key COVID-19 Protective Responses: Findings From a Randomized Online Experiment

Communication Strategies to Promote COVID-19 Vaccination Intention: How Effective are Source, Appeal, Framing, and Evidence Type Approaches?

This systematic review analyzed the effectiveness of key persuasive strategies - source, appeal, framing, and evidence (SAFE) - on COVID-19 vaccination intention. Quantitative studies were searched in Web of Science, Scopus, and PubMed following the PRISMA guidelines. From the 61 studies that met inclusion criteria, source and framing are the most commonly applied SAFE strategies. However, source characteristics are a more consistent influence on vaccine intentions than message framing strategies, with expert sources and general practitioners emerging as the key sources contributing to greater vaccine intentions. In addition, a range of mediators and moderators influence the process through which SAFE message strategies impact vaccine intentions. Framing effects, in particular, are moderated by political identity, source characteristics, and vaccine perceptions. Tests of mediating processes highlight how health behavior judgments (e.g. perceived vaccine benefits, risks, trust in vaccination, perceived severity) and message response/perceptions (e.g. counterarguing, perceived similarity/empathy) operate as key intervening factors between SAFE message strategies and vaccine intentions. Overall, when practitioners apply various structural approaches (narrative elements, fear appeals, framing cues) to vaccine promotion campaigns, they should be cognizant of who is providing that appeal. Targeted populations may benefit most from different structural elements if they are integrated with sources that resonate with the audience.

Audience Response to COVID Monologues: Research-Based Theater on the Societal Impact of COVID-19

PURPOSE

Research-based theater uses drama to communicate research findings to audiences beyond those that typically read peer-reviewed journals. We applied research-based theater to translate qualitative research findings on the impact of the COVID-19 pandemic on different segments of U.S. society.

APPROACH

Theater artists and public health researchers collaborated to create a collection of eight monologues from systematically sourced, peer-reviewed publications. Following three virtual performances in Spring, 2021, audience members were invited to complete a survey.

SETTING/PARTICIPANTS

Audience survey respondents (n = 120) were mostly U.S.-based and were diverse in terms of age, race/ethnicity, gender, profession, and experience attending theater.

METHOD

We summarized closed-ended responses and explored patterns by demographic characteristics. We synthesized themes of open-ended responses with inductive coding.

RESULTS

Audience members somewhat/strongly agreed that COVID Monologues increased their knowledge (79.4%), represented the reality of the U.S. COVID-19 epidemic (95.7%), and offered new perspectives on what people had been experiencing (87.5%). Most also agreed research-based theater is an effective means of understanding health research (93.5%) and can promote community resilience in times of public health crisis (83.2%). Mann-Whitney U tests suggested less positive reactions from demographics that were not well-represented in monologue characters (cisgender men, Hispanics). Qualitative comments suggested audience members valued monologues that offered self-reflection and validation of their own COVID-19 experiences through relatable characters as well as those that offered insight into the experiences of people different from themselves.

CONCLUSION

This work adds to evidence that research-based theater can help build knowledge and emotional insight around a public health issue. As these elements are foundational to pro-social, preventative health behaviors, research-based theater may have a useful role in promoting collective response to public health crises like COVID-19. Our method of systematically-sourcing research for theater-based dissemination could be extended to target more specific audiences with actionable behaviors.

Addressing message fatigue for encouraging COVID-19 vaccination

During the prolonged COVID-19 pandemic, health communication researchers and practitioners should be aware of the unintended effects of message fatigue. Message fatigue is a motivational state caused by repeated and prolonged exposure to similar health-related messages that induces resistance to health behaviors. Messages encouraging COVID-19 vaccination tend to focus on scientific evidence and efficacy information. However, prolonged exposure to similarly framed repeated pro-COVID-19 vaccination messages may cause message fatigue, generate psychological reactance, and lead to ineffective persuasive outcomes. Scholars of message fatigue argue that health communication practitioners should select a less common frame to reduce fatigue responses and increase favorable attitudes toward message recommendations. Entering the second year since COVID-19 vaccination has begun, to reduce message fatigue, future pro-COVID-19 vaccination communication should increase the diversity of messages different than the frequently used types. This opinion piece proposes alternative dissemination of cognitive, affective, narrative, and non-narrative pro-COVID-19 vaccination messages.

Factors Associated With COVID-19 Behavioral Intentions: Findings From an Online Survey

Purpose

The COVID-19 pandemic provides a novel context through which to evaluate salient factors for promoting behavioral change. We examined how attitudes, perceived community behaviors, and prior related behaviors predict intentions to (1) receive COVID-19 vaccination and (2) practice social distancing.

Design

Cross-sectional online survey administered through Amazon’s Mechanical Turk in September 2020.

Subjects

A convenience sample of US adults (N = 1804).

Measures

COVID-19 vaccination and social distancing intentions were measured on a 7-point Likert scale. Predictor variables included general vaccination and social distancing attitudes, perceived community mask-wearing, prior influenza vaccination, prior social distancing, and socio-demographics.

Analysis

Descriptive statistics and linear regressions.

Results

Thirty percent of respondents reported a strong willingness to receive COVID-19 vaccination, while 67% strongly intended to engage in social distancing. In regression analyses, vaccination intention was predicted by positive vaccine attitudes (b = .84; 95%CI: .78, .90; P < .001), prior influenza vaccination (b = −.47; 95%CI: −.63, −.32; P < .001), and perceived community mask-wearing (b = −.28; 95%CI: −.56, −.01; P=.049). Intention to practice social distancing was predicted by positive attitudes (b = .65; 95%CI: .61, .69; P < .001), prior social distancing (b = −.49; 95%CI: −.59, −.39; P < .001), and perceived community mask-wearing (b = −.28; 95%CI: −.46, −.09; P = .003).

Conclusion

Findings have implications for health promotion efforts. Messages that are targeted and tailored on pre-existing attitudes may be more effective. Additionally, leveraging prior behaviors and perceived community behavior may improve communication strategies.