HPV Vaccine Searches on Pinterest: Before and After Pinterest's Actions to Moderate Content

Discovering why people believe disinformation about healthcare

Disinformation-false information intended to cause harm or for profit-is pervasive. While disinformation exists in several domains, one area with great potential for personal harm from disinformation is healthcare. The amount of disinformation about health issues on social media has grown dramatically over the past several years, particularly in response to the COVID-19 pandemic. The study described in this paper sought to determine the characteristics of multimedia social network posts that lead them to believe and potentially act on healthcare disinformation. The study was conducted in a neuroscience laboratory in early 2022. Twenty-six study participants each viewed a series of 20 either honest or dishonest social media posts, dealing with various aspects of healthcare. They were asked to determine if the posts were true or false and then to provide the reasoning behind their choices. Participant gaze was captured through eye tracking technology and investigated through "area of interest" analysis. This approach has the potential to discover the elements of disinformation that help convince the viewer a given post is true. Participants detected the true nature of the posts they were exposed to 69% of the time. Overall, the source of the post, whether its claims seemed reasonable, and the look and feel of the post were the most important reasons they cited for determining whether it was true or false. Based on the eye tracking data collected, the factors most associated with successfully detecting disinformation were the total number of fixations on key words and the total number of revisits to source information. The findings suggest the outlines of generalizations about why people believe online disinformation, suggesting a basis for the development of mid-range theory.

Promotion of an Algorithm-Based Tool for Pregnancy Prevention by Instagram Influencers

Objective: Despite growing concerns that some digital algorithm-reliant fertility awareness-based methods of pregnancy prevention are marketed in an inaccurate, opaque, and potentially harmful manner online, there has been limited systematic examination of such marketing practices. This article therefore provides an empirical examination of how social media influencers have promoted the fertility tracking tool Daysy on Instagram. We investigate: (1) how the tool is framed in relation to pregnancy prevention using Health Belief Model (HBM) constructs, and (2) the promotional and disclosure practices adopted by influencers. Materials and Methods: We collected Instagram posts mentioning Daysy made between June 2018 and May 2022 using the tool CrowdTangle. Using a qualitative content analysis approach, we coded a random sample of 400 Daysy posts. This yielded 122 Instagram influencer posts promoting Daysy for pregnancy prevention that we coded for promotional content and HBM constructs. Results: Posts originated primarily from Europe (n = 62, 50.82%) and the United States (n = 37, 30.33%). Findings indicate that barriers to use (n = 18, 15.57%) and the severity of risks from unplanned pregnancy (n = 8, 6.56%) were rarely conveyed, whereas benefits of use (n = 122, 100%) and the severity of risks of hormonal contraception (n = 31, 25.41%) were covered more extensively. Only about one third of posts disclosed any formal relationship to the brand Daysy. Conclusions: With many posts emphasizing benefits and obscuring potential limitations, we argue that accurate and transparent information about the effectiveness and limitations of fertility tracking technologies is critical for supporting informed decision-making and, as such, should remain a public health priority.

Oh Baby! A Content Analysis of Contraception Pins on Pinterest

BACKGROUND

Social media platforms have become a popular source for health information despite concerns about the quality of content shared. We examined how oral contraceptive pills and intrauterine devices are framed on the platform Pinterest using the Health Belief Model (HBM), as well as how fertility awareness methods are portrayed as an alternative to hormonal contraception.

METHODS

We collected pins in February 2021 using searches for birth control, oral contraceptives, and intrauterine devices. After excluding paid ads and pins not relevant to contraceptive use, we conducted a content analysis of 404 pins using a coding framework grounded in the HBM. We carried out descriptive statistics for all variables in the final sample.

RESULTS

Following coding, we found that 54.7% of pins mentioned oral contraceptive pills, 41.58% mentioned intrauterine devices, and 11.63% mentioned fertility awareness methods. Fertility awareness pins had the highest percentage of benefits conveyed (70.21%), followed by intrauterine devices (44.05%), then oral contraceptive pills (38.91%). Pill pins had the highest percentage of barriers conveyed (52.94%) and fertility awareness had the least (25.53%). Side effects were the most mentioned barrier among pill (37.10%) and intrauterine device pins (23.21%). Very few pins were made by (2.48%) or originated with medical institutions (5.45%).

CONCLUSIONS

Oral contraceptive pills are often negatively framed on Pinterest, whereas intrauterine devices and fertility awareness methods are more positively framed. This suggests a need for clear communication from clinicians regarding all contraceptive options and their relative merits and risks.

Addressing Viral Medical Rumors and False or Misleading Information

The rapid spread of medical rumors and false or misleading information on social media during times of uncertainty is a vexing challenge that threatens public health. Understanding the information ecosystem, social media networks, and the scope of incentives that drive users and social media platforms can provide critical insights for strong coordination between stakeholders and funders to address this challenge. The COVID-19 pandemic created an opportunity to demonstrate the role of media monitoring and counter-messaging efforts in responding to dangerous medical rumors, misinformation, and disinformation. It also highlighted the challenges. The efforts of ThisIsOurShot and VacunateYa to spread accurate health information about COVID-19 and COVID-19 vaccines are described and lessons learned are discussed. These lessons include the need for substantial financial investments at the local and national levels to sustain and scale these types of programs. Examples in other fields that offer a path forward include Information Sharing and Analysis Centers and Public Health Emergency Operations Centers. Understanding the scale and scope of what it takes to address viral medical rumors, misinformation, and disinformation in a networked information environment should inspire elected leaders to consider policy and regulatory reforms. Our transformed information ecosystem requires new public health infrastructure to address information that threatens personal safety and population health.

Parental Knowledge, Attitudes, and Perceptions Impacting Willingness to Vaccinate Against the Human Papillomavirus in Trinidad

Background Cervical cancer remains a major cause of morbidity and mortality in young women in Trinidad and Tobago. This study aimed to determine the knowledge, attitudes, perceptions, and beliefs of Trinidadian parents toward human papillomavirus (HPV) vaccination. In addition, factors predictive of willingness to vaccinate were explored. Methodology In this cross-sectional study conducted between March and May 2019, a paper-based survey was self-administered to parents of children in the 5-12-year age group in seven geographically representative Trinidadian primary schools. Results Of the 420 questionnaires distributed, 160 were returned completed (38% response rate). General knowledge that HPV causes cervical cancer and genital warts and is spread by sexual contact was common among 81%, 71%, and 81% of parents, respectively. At least 40% of the respondents expressed uncertainty about the vaccine's long-lasting health problems and its effectiveness in preventing genital warts and cervical cancer. Half of the parents were unsure if the vaccine was harmful. The perceptions that vaccine safety data are fabricated, drug companies cover up the dangers of vaccines, vaccine efficacy data are often fabricated, people are deceived about vaccine efficacy and safety, and conspiracy beliefs were held by 15.5%, 26.1%, 13%, 21.7%, and 28.5% of parents, respectively. There was a negative correlation between knowledge and conspiracy belief scores (ρ = -0.30, p < 0.001). Overall, 45.3% of parents were willing to immunize their children against HPV. Being informed about HPV by a health professional (odds ratio (OR) = 2.9, 95% confidence interval (CI) 1.5-5.8), knowledge of the benefits (OR = 4.6, 95% CI = 2.2-9.6), and a health professional offering the option of vaccination (OR = 3.7, 95% CI = 1.7-8.0) were associated with significantly increased odds of parents willing to vaccinate their child. The agreement that vaccine safety data are often fabricated (OR = 0.31, 95% CI = 0.12-0.84), pharmaceutical companies cover up the dangers of vaccines (OR = 0.14, 95% CI = 0.06-0.37), waiting at the clinic being time-consuming (OR = 0.37, 95% CI = 0.15-0.89), and the beliefs that adolescents are too young to get a vaccine to prevent sexually transmitted disease (OR = 0.16, 95% CI = 0.11-0.83) were associated with a significantly decreased willingness to vaccinate. Conclusions While general knowledge about HPV was high, there remain several areas for parental education regarding the HPV vaccine. Misbeliefs need to be addressed and multilevel interventions are needed to improve HPV vaccine uptake in our setting.

Cross-platform spread: vaccine-related content, sources, and conspiracy theories in YouTube videos shared in early Twitter COVID-19 conversations

High uptake of vaccinations is essential in fighting infectious diseases, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes the ongoing coronavirus disease 2019 (COVID-19) pandemic. Social media play a crucial role in propagating misinformation about vaccination, including through conspiracy theories and can negatively impact trust in vaccination. Users typically engage with multiple social media platforms; however, little is known about the role and content of cross-platform use in spreading vaccination-related information. This study examined the content and dynamics of YouTube videos shared in vaccine-related tweets posted to COVID-19 conversations before the COVID-19 vaccine rollout. We screened approximately 144 million tweets posted to COVID-19 conversations and identified 930,539 unique tweets in English that discussed vaccinations posted between 1 February and 23 June 2020. We then identified links to 2,097 unique YouTube videos that were tweeted. Analysis of the video transcripts using Latent Dirichlet Allocation topic modeling and independent coders indicate the dominance of conspiracy theories. Following the World Health Organization's declaration of the COVID-19 outbreak as a public health emergency of international concern, anti-vaccination frames rapidly transitioned from claiming that vaccines cause autism to pandemic conspiracy theories, often featuring Bill Gates. Content analysis of the 20 most tweeted videos revealed that the majority (n = 15) opposed vaccination and included conspiracy theories. Their spread on Twitter was consistent with spamming and coordinated efforts. These findings show the role of cross-platform sharing of YouTube videos over Twitter as a strategy to propagate primarily anti-vaccination messages. Future policies and interventions should consider how to counteract misinformation spread via such cross-platform activities.

State Health Department Communication about Long COVID in the United States on Facebook: Risks, Prevention, and Support

Greater public awareness of long COVID severity and susceptibility is needed to support those with long COVID and encourage preventive behaviors. It is not yet known to what extent health departments have informed the public about long COVID risks or offered guidance and support for those with long COVID. The objective of this research was to determine how and to what extent US state health departments have communicated with the public about long COVID via Facebook. Facebook posts with COVID-19 and long COVID terms made by 50 US state health departments plus Washington, DC, from 1 January 2020 to 31 January 2022, were collected using CrowdTangle. The first long COVID post appeared on 15 July 2020. From 15 July 2020 to 31 January 2022, state health departments made 49,310 COVID-19 posts and 137 long COVID posts. Using quantitative content analysis methods, long COVID posts were coded for health belief model constructs. Among long COVID posts, 75.18% included language about susceptibility, 64.96% severity, and 64.23% benefits of prevention. Cues to preventive action appeared in 54.01% of posts. 19.71% of posts provided guidance for those with long COVID. While health departments posted extensively about COVID-19, posts about long COVID were rare. This represents a missed opportunity to bolster arguments for preventive behaviors and support those experiencing long COVID.

Social media-assisted interventions on human papillomavirus and vaccination-related knowledge, intention and behavior: a scoping review

Social media holds the potential to engage adolescents and young adults and to facilitate interventions improving Human Papillomavirus Vaccine (HPVV). This article systematically reviewed the literature on Cochrane Library, PubMed, Web of Science, EMBASE, Scopus and CINAHL. Interventions delivered or facilitated by social media with outcomes of HPV-related knowledge, awareness, attitude, vaccination intention and behavior were included. Standardized forms were used to abstract the basic characteristics, settings, guiding theories and key findings of the interventions. Twenty-four studies met the eligibility criteria. Sixteen were educational interventions, and the other eight investigated the effect of social media message contents on improving Human Papillomavirus (HPV)-related outcomes. The studies were published between 2015 and 2021. The most frequently used social media platforms were Facebook, and the most commonly adopted theory was the health belief model (HBM). Existing interventions have shown preliminary but promising effects in improving HPV awareness and knowledge. Still, such improvements have not always been translated to improved behavioral intentions and vaccination rates. The contents and phrasing of social media messages and pre-existing individual characteristics of social media users moderated intervention effectiveness. Social media could be a valuable tool for engaging participants and delivering HPV interventions. Future interventions should apply stronger theory bases.

The impact of Facebook's vaccine misinformation policy on user endorsements of vaccine content: An interrupted time series analysis

OBJECTIVES

To evaluate the impact of Facebook's vaccine misinformation policy in March 2019 on user endorsements of vaccine content on its platform.

METHODS

We identified 172 anti- and pro-vaccine Facebook Pages and collected posts from these Pages six months before and after the policy. Using interrupted time series regression models, we evaluated the policy impact on user endorsements (i.e., likes) of anti- and pro-vaccine posts on Facebook.

RESULTS

The number of likes for posts on anti-vaccine Pages had decreased after the policy implementation (policy = 153.2, p < 0.05; policy*day = -0.838, p < 0.05; marginal effect at the mean = -22.74, p < 0.01; marginal effect at the median = -24.56, p < 0.01). When the number of subscribers was considered, the policy effect on the number of likes for anti-vaccine posts was much smaller, but still statistically significant (policy = 4.849, p < 0.05; policy*day = -0.027, p < 0.05; marginal effect at the mean = -0.742, p < 0.01; marginal effect at the median = -0.800, p < 0.01). There was no policy effect observed for posts on pro-vaccine Pages.

CONCLUSIONS

Our analysis suggested that Facebook's March 2019 vaccine misinformation policy moderately impacted the number of endorsements of anti-vaccine content on its platform. Social media companies can take measures to limit the popularity of anti-vaccine content by reducing their reach and visibility. Future research efforts should focus on evaluating additional policies and examining policies across platforms.

Parent support for social media standards combatting vaccine misinformation

We sought to assess parental support for varying standards that social media sites can employ to combat vaccine misinformation. Between July and August 2019, we conducted a web-based survey with a national sample of 1073 parents of adolescents and who use social media. The survey assessed support for ten standards about vaccine misinformation. Multivariable logistic regression assessed correlates of support. Overall, 61% of parents supported at least one standard. Support for each standard varied greatly (12-51%), with higher support for less restrictive standards. Parents more often supported standards if their child had already initiated human papillomavirus (HPV) vaccination, if they were non-Hispanic black or Hispanic, if they agreed that vaccine misinformation is harmful, or if they saw information on social media in favor of HPV vaccine (all p < .05). Our findings suggest favorable support for standards that social media sites can implement to combat vaccine misinformation.