Rhetorical Appeals and Tactics in New York Times Comments About Vaccines: Qualitative Analysis

Perceived Effectiveness of COVID-19 Preventive Practices and Behavioral Intention: Survey of a Representative Adult Sample in the United States

BACKGROUND

Using existing models of behavioral health promotion, specifically the Extended Parallel Process Model, previous research has identified factors that may impact engagement in preventive health behaviors during the COVID-19 pandemic such as perceived threat, perceived susceptibility to the threat, perceived severity, and perceived efficacy.

OBJECTIVE

This study aims to examine the role of perceived effectiveness of COVID-19 preventive behaviors, perceived susceptibility, perceived threat, and perceived severity of COVID-19 in participants' intentions to engage in Centers for Disease Control (CDC)-recommended individual health behaviors in the first year of the pandemic.

METHODS

In October 2020, a representative sample of 506 US adults completed a web-based survey through the RAND American Life Panel.

RESULTS

The study primarily found that participants who perceived that CDC-recommended health practices were effective had stronger intentions to engage in those practices. The second strongest correlate was participants' perceived severity of COVID-19 across the United States. Perceived effectiveness of recommended practices accounted for the largest variance in behavioral intention. However, analysis of individual behaviors indicated a mismatch in the behaviors perceived to be the most effective (avoiding sick people and mask-wearing) and those participants indicated intention to engage in (throwing away used tissues, avoiding sick people, and coughing into their elbows) in the next 30 days.

CONCLUSIONS

The authors recommend tailoring public health messaging to address the perceived threat of COVID-19 and self-efficacy. Thus, health promotion efforts should emphasize the effectiveness of CDC-recommended practices while highlighting the pandemic's severity. Additionally, rebuilding trust in public health messaging and messengers is necessary to increase perceived self-efficacy. As the COVID-19 pandemic continues, health messaging must continue to promote and build trust in CDC-recommended health practices and educate regarding the efficacy of vaccination and other preventive behaviors.

A taxonomy of anti-vaccination arguments from a systematic literature review and text modelling

The proliferation of anti-vaccination arguments is a threat to the success of many immunization programmes. Effective rebuttal of contrarian arguments requires an approach that goes beyond addressing flaws in the arguments, by also considering the attitude roots-that is, the underlying psychological attributes driving a person's belief-of opposition to vaccines. Here, through a pre-registered systematic literature review of 152 scientific articles and thematic analysis of anti-vaccination arguments, we developed a hierarchical taxonomy that relates common arguments and themes to 11 attitude roots that explain why an individual might express opposition to vaccination. We further validated our taxonomy on coronavirus disease 2019 anti-vaccination misinformation, through a combination of human coding and machine learning using natural language processing algorithms. Overall, the taxonomy serves as a theoretical framework to link expressed opposition of vaccines to their underlying psychological processes. This enables future work to develop targeted rebuttals and other interventions that address the underlying motives of anti-vaccination arguments.

Who's a Vaccine Skeptic? Framing Vaccine Hesitancy in Post-Covid News Coverage

U.S. print news coverage of Covid vaccine hesitancy represents a departure from previous depictions of vaccine skepticism as a problem of wrong belief. This article reports on a mixed methods study of 334 New York Times texts about Covid nonvaccination and vaccine hesitancy published between December 2020-December 2021. Texts were analyzed for common themes and compared with prior media depictions of vaccine skepticism. Findings show that texts published during phased Covid vaccine distribution framed nonvaccination as a response to structural inequities, while later texts returned to blaming individuals for their hesitancy. These findings attest to the durability of individualistic framings of health while also illustrating possibilities of alternative frames.

Balanced Reporting and Boomerang Effect: An Analysis of Croatian Online News Sites Vaccination Coverage and User Comments during the COVID-19 Pandemic

The purpose of this paper was to explore online media coverage of COVID-19 vaccination and user reactions to the different types of coverage. The authors aimed to investigate possible boomerang effects that arise when COVID-19 media coverage is assertive and confident, and to determine the effects of balanced reporting. A two-stage random sample comprised a total of 300 articles published in three Croatian online news sites during a period from 1 February 2020, through 15 January 2022. The data were categorized using human coding content analysis, while reliability of coding was checked by using two coders and calculating reliability coefficients. The data were analyzed by means of negative binomial regression analysis. The results revealed that COVID-19 reporting was mainly consensual, i.e., it provided largely affirmative information about vaccines. However, user comments were highly polarized and mostly negative, with the majority of anti-vaccination tropes linked to the "corrupt elites". Based on the user comments, the negative influence of balanced reporting on COVID-19 vaccines and the existence of boomerang effect in cases of the overtly persuasive affirmative reporting was also established. The boomerang effect did not depend on the context, i.e., on the type of reporting. This study extends previous research on balanced reporting and boomerang effects by analyzing online comments as a potentially good parallelism of the offline discursive strategies of the pro-vaccination and anti-vaccination communication. The results of the study can be used for the adjustment of strategic communication targeting the vaccine hesitant audience. Based on the study results, it is recommended that relativization and politicization of science should be prevented by not equating scientific consensus with absolute epistemological certainty and by addressing legitimate concerns of vaccine hesitant persons without putting explicit blame on them.

Defending and refuting information sources rhetorically: The case of COVID-19 vaccination

This investigation compares how COVID-19 vaccination supporters and refusers make use of rhetorical strategies to judge the credibility of information sources in online discussion. To this end, the Aristotelian tripartite approach to rhetoric, that is, ethos, pathos and logos was utilized. The empirical findings draw on the analysis of 2257 posts submitted to Suomi24—a Finnish online discussion in May—October 2021. The findings indicate that both vaccine supporters and vaccine refusers mainly drew on the pathos- and ethos-related rhetorical strategies such as appeal to blameworthiness and ad hominem arguments while judging the credibility of information sources. Coronavirus vaccination appeared to be a highly contested topic giving rise to polarized debates, deep mistrust and mutual accusations between opposing parties. The rhetorical strategies were used to attack opponents’ views on the credibility of information sources, rather than making attempts to create mutual understanding of their value for arguments used in online discussion.

The Effects of Website Traits and Medical Skepticism on Patients' Willingness to Follow Web-Based Medical Advice: Web-Based Experiment

Background

As people increasingly turn to web-based sources for medical information, we offer some insight into what website traits influence patients’ credibility assessment. Specifically, we control for brand and content length, while manipulating three website traits: authorship, format, and tone. Furthermore, we focus on medical skepticism to understand how patients with high levels of medical skepticism may react to web-based medical information differently. Medical skepticism is related to a patient’s doubts about the value of conventional medical care; therefore, skeptics may have different practices and criteria when conducting their own web-based medical searches.

Objective

The aim of this study is to evaluate how website traits affect the likelihood that patients follow web-based medical advice and how this varies among patients with differing levels of medical skepticism.

Methods

This web-based experiment presented participants with a hypothetical medical situation about leg cramps and offered a website with treatment advice. We varied the websites the participants observed across three traits: authorship (patient or physician), format (article or discussion forum), and tone (objective or experience-based). The 2305 participants were randomly assigned to 1 of 8 possible conditions and then asked the extent to which they would follow the advice. Health care patterns and coverage, demographics, and the participants’ level of medical skepticism were captured.

Results

Our participants were selected to be demographically representative of the population of internet users in the United States. The 2305 complete responses were analyzed with ordinary least squares regression. Our analysis reveals that people are more likely to accept web-based medical advice authored by a physician (P<.001) and presented with an objective tone (P=.006), but these preferences erode as the levels of medical skepticism increase. Medical skepticism was measured by means of a previously established index on a 0 to 4 scale, and the average score was 2.26 (SD 0.84). Individuals with higher levels of medical skepticism were more likely to follow web-based medical advice in our experiment (P<.001). Individuals with low levels of medical skepticism found the discussion forum format more credible, whereas those with high levels of medical skepticism preferred the article format (P=.03). We discuss the interactions between medical skepticism and all 3 website traits manipulated in the experiment.

Conclusions

Our findings suggest that, generally, physician authorship and an objective tone create more persuasive web-based medical advice. However, there are differences in how patients with high levels of medical skepticism react to web-based medical resources. Medical skeptics are less discerning regarding the author’s credentials and the presentation tone of the information. Furthermore, patients with higher levels of medical skepticism prefer article format presentations, whereas those with lower levels of medical skepticism prefer discussion forum–style formatting.