How Media Literacy, Trust of Experts and Flu Vaccine Behaviors Associated with COVID-19 Vaccine Intentions

The resilience of attitude toward vaccination: A web-based randomized controlled trial on the processing of online (mis)information

BACKGROUND

Before the COVID-19 pandemic, it was already recognized that internet-based misinformation and disinformation could influence individuals to refuse or delay vaccination for themselves, their families, or their child(ren). Reinformation, which refers to hyperpartisan and ideologically biased content, can propagate polarizing messages on vaccines, thereby contributing to vaccine hesitancy even if it is not outright disinformation.

OBJECTIVE

This study aimed to evaluate the impact of online reinformation on vaccine hesitancy. Specifically, our goal was to investigate how misinformation presented in the style and layout of a news article could influence the perceived tentativeness (credibility) of COVID-19 vaccine information and confidence in COVID-19 vaccination.

METHODS

We conducted a web-based randomized controlled trial (RCT) by recruiting English-speaking Canadians aged 18 years and above from across Canada through the Qualtrics paid opt-in panel system. Participants were randomly assigned to one of four distinct versions of a news article on COVID-19 vaccines, each featuring variations in writing style and presentation layout. After reading the news article, participants self-assessed the tentativeness of the information provided, their confidence in COVID-19 vaccines, and their attitude toward vaccination in general.

RESULTS

The survey included 537 participants, with 12 excluded for not meeting the task completion time. The final sample comprised 525 participants distributed about equally across the four news article versions. Chi-square (χ2) analyses revealed a statistically significant association between general attitude toward vaccination and the perceived tentativeness of the information about COVID-19 vaccines included in the news article (χ21 = 37.79, P<.0001). The effect size was small to moderate, with Cramer's V = 0.27. An interaction was found between vaccine attitude and writing style (χ²₁ = 6.17, P= 0.01), with a small effect size, Cramer's V = 0.11. Additionally, a Pearson correlation revealed a significant moderate-to-strong correlation between perceived tentativeness and confidence in COVID-19 vaccination, r(523) = .48, P<.0001. The coefficient of determination (r²) was 0.23, indicating that 23% of the variance in perceived tentativeness was explained by confidence in COVID-19 vaccines. In comparing participants exposed to a journalistic-style news article with those exposed to an ideologically biased article, Cohen's d was calculated to be 0.38, indicating a small to medium effect size for the difference in the perceived tentativeness between these groups.

CONCLUSIONS

Exposure to an online news article conveying misinformation may not be sufficient to change an individual's level of vaccine hesitancy. The study reveals that the predominant factor in shaping individuals' perception of COVID-19 vaccines is their attitude toward vaccination in general. This attitude also moderates the influence of writing style on perceived tentativeness; the stronger one's opposition to vaccines, the less pronounced the impact of writing style on perceived tentativeness.

CLINICALTRIAL

The study was part of a broader initiative with a registered protocol. The protocol was recorded on October 17, 2022, under the International Registered Report Identifier (IRRID): DERR1-10.2196/41012.

INTERNATIONAL REGISTERED REPORT

RR2-10.2196/41012.

Media Health Literacy in Spanish Nursing Students: A Multicenter Cross-Sectional Study

BACKGROUND

Amidst current misinformation, media literacy is an essential competency for nursing professionals. This study aimed to analyze the level of media health literacy among Spanish undergraduate nursing students, stratifying the results by gender, region, and other associated factors.

METHODS

A cross-sectional study was conducted at five Spanish universities (N = 416) using the Spanish version of the Media Health Literacy (MeHLit-SV) Questionnaire.

RESULTS

Students presented an average media health literacy score of 48.73 points. The media health literacy level was significantly higher among students from universities in the central and northeastern regions of Spain (ANOVA Test, p = 0.0002), those who had previously studied in a city (ANOVA Test, p = 0.001), those who combined their studies with employment (ANOVA Test, p = 0.001), and those residing in communities with fewer than 500 inhabitants (ANOVA Test, p = 0.001). No differences were found based on gender.

CONCLUSIONS

The media health literacy level of the students was deficient and varied according to socio-economic and socio-educational factors. Understanding the literacy level of future nurses and promoting the inclusion of this competency in their education will enable them to become leaders in improving the population's health self-care.

Media Literacy and Its Potential Influence on Mpox-Related Perceptions and Prevention Intentions in China During the 2022 Multi-Country Outbreak of Mpox

Media literacy plays an increasingly important role in health communication during public health emergencies. The present study aimed to investigate the level of media literacy and its association with disease perceptions and behavioral intentions of receiving vaccination services among young men who have sex with men (YMSM) in China during the 2022 multi-country mpox outbreak. The data were from a large-scale cross-sectional survey conducted among 2,493 YMSM aged 18-29 years in six provincial regions in China in September 2022. A total of 2,079 YMSM who had obtained mpox information from social media platforms were included in this study. Correlation analysis and path analysis were conducted. The mean age of the sample was 24.7. After controlling for background variables, significant positive correlations were found in several pairs between media literacy, mpox-related perceptions (including perceived susceptibility to mpox, perceived severity of mpox, perceived benefits of mpox vaccination, and self-efficacy of receiving mpox vaccination), and the behavioral intention of receiving mpox vaccination. The mpox-related perceptions played a significant mediation role in the association between media literacy and intention of receiving mpox vaccination (indirect effect = 0.165, p < .001, effect size = 82.1%). Media literacy is crucial for developing disease perceptions during public health emergencies and may further influence the adoption of preventive measures. As social media platforms have become the main battle field of health communication during disease outbreaks, improvement of media literacy is urgently warranted.

Integrating Science Media Literacy, Motivational Interviewing, and Neuromarketing Science to Increase Vaccine Education Confidence among U.S. Extension Professionals

This article presents an Integrative Model of Sustainable Health Decision-Making and a toolkit to equip U.S. Extension professionals with knowledge and skills to engage in adult immunization education. The objective was to reduce mistrust and increase willingness and confidence toward delivering vaccination education. The model was developed through an explanatory parallel mixed methods design. Data collection included a needs assessment survey, interviews, workshops, and Neuromarketing message testing. The resulting toolkit was pilot tested before final delivery. Four key needs were identified: tailoring trainings based on Extension roles, prioritizing preserving community trust and professional credibility, establishing connections with medical experts, and strengthening Science Media Literacy skills to counter misinformation and communicate emerging science. Correlations among constructs supported an integrated model focused on a professional development core of Science Media Literacy, Motivational Interviewing, and Neuromarketing Science that strengthens communication relationships between priority populations and trusted partners. The model and work described in this article can serve as a general framework for engaging key influencers in communities in communication education intended to promote sustainable well-being, such as increasing vaccine uptake.

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.

Exploring the Dunning-Kruger Effect in Health Communication: How Perceived Food and Media Literacy and Actual Knowledge Drift Apart When Evaluating Misleading Food Advertising

Marketers often advertise products high in sugar, fat or calories as healthy products. With this potentially misleading information, they can influence eating decisions with negative consequences for human health. Consumers need the ability to uncover misleading food advertising. However, individuals' perceived knowledge and their actual objective abilities often drift apart - a phenomenon which has come to be known as the Dunning-Kruger Effect. Thus, this study set out to uncover the phenomenon's potential existence in health communication, more precisely in the area of food and media literacy. In a quantitative survey representative of the Austrian population (n = 1000) the Dunning-Kruger Effect (DKE) could be detected: Individuals who were most knowledgeable underestimated their food and media literacy, but - on the positive side - they acted as opinion leaders. Individuals who were least knowledgeable about advertising strategies used to market an unhealthy product as healthy and about the actual nutrition score of the advertised product were most likely to overestimate their own food and media literacy. Worryingly, further concerning consequences emerged, especially for least knowledgeable individuals. The study's results provide important implications for public health campaigns.

Racial residential segregation and COVID-19 vaccine uptake: an analysis of Georgia USA county-level data

BACKGROUND

Foundational literature demonstrates that racial residential segregation results in poorer health outcomes for Black people than white people due to a variety of social determinants of health. COVID-19 vaccine uptake is important for better health outcomes, regardless of race. The COVID-19 pandemic has elevated concerns about racial health disparities but with little discussion of racial residential segregation as a predictor of disparate health outcomes. This paper investigates the relationship between racial residential segregation and COVID-19 vaccine uptake using county level data from the State of Georgia (USA).

METHODS

Using publicly available data, regression analysis is conducted for 138 of the 159 counties in Georgia USA, using a dissimilarity index that describes county level differences in racial residential segregation. The primary independent variable is Black-white differences in vaccine uptake at the county level. The analytic methods focus on a spatial analysis to support information for county level health departments as the basis for health policy and resource allocation.

RESULTS

Constructing a variable of the difference in vaccination rates between Black and white residents we find that Black-white differences in COVID-19 vaccination are most notable in the 69 most segregated of the 159 counties in Georgia. A ten-point lower segregation index is associated with an improvement in the Black-white vaccination gap of 1.5 percentage points (95% CI -0.31, -0.00). Income inequality and access to health care resources, such as access to a primary care physician, also predict Black-white differences in vaccination rates at the county level. Suggested mapping approaches of publicly available data at a state county level, provides a resource for local policy makers to address future challenges for epidemic and pandemic situations.

CONCLUSION

County level and geospatial data analysis can inform policy makers addressing the impact of racial residential segregation on local health outcomes, even for pandemic and epidemic issues.