Unfolding COVID-19 vaccine communication campaigns in China's neighborhoods: a qualitative study of stakeholders' narratives

Introduction

The Chinese state has recently implemented the COVID-19 Vaccine Communication Campaign (CVCC) to counter vaccine hesitancy. Nonetheless, the extant literature that examines COVID-19 vaccine acceptance has less represented COVID-19 vaccine communication efforts.

Methods

To address this lacuna, we qualitatively explored how CVCCs were organized in Chinese communities by investigating 54 Chinese stakeholders.

Results

This study indicates that the CVCC was sustained by top-down political pressure. CVCCs' components involve ideological education among politically affiliated health workers, expanding health worker networks, training health workers, implementing media promotion, communicating with residents using persuasive and explanatory techniques, encouraging multistakeholder partnerships, and using public opinion-steered and coercive approaches. While CVCCs significantly enhanced COVID-19 vaccine acceptance, lacking open communication, stigmatizing vaccine refusers, insufficient stakeholder collaboration, and low trust in the COVID-19 vaccination program (CVP) eroded the validity of CVCCs.

Discussion

To promote the continuity of CVCCs in China, CVCC performers are expected to conduct open and inclusive communication with residents. Furthermore, CVP planers should create robust partnerships among health workers by ensuring their agreements on strategies for implementing CVCCs and optimize COVID-19 immunization service provision to depoliticize CVPs. Our study will not only deepen global audiences' understanding of CVCCs in authoritarian China but also offer potential neighborhood-level solutions for implementing local and global public health communication efforts.

Framing Effects on Willingness and Perceptions towards COVID-19 Vaccination among University Students in Italy: An Exploratory Study

Vaccine hesitancy is a diffused psychological phenomenon that has been increasingly addressed in several studies since the COVID-19 pandemic. Communication campaigns play a pivotal role influencing recipients' perceptions and may affect the likelihood to vaccinate or to show hesitancy. In the context of communicating risks during the COVID-19 pandemic, we hypothesized that highlighting different aspects of data on the effectiveness of vaccines would influence people's willingness and attitudes to vaccinate. In this exploratory study, we administered two versions of a survey to a convenience sample of students from three universities in Italy. In the first version, salience was placed on the effectiveness of the vaccine in terms of reducing the probability of infection. In the second version, salience was placed on the effectiveness of the vaccine in terms of reducing the probability of hospitalization after being infected by COVID-19. The results confirmed our hypothesis: participants reported that they were more willing to become vaccinated when exposed to the hospitalization frame (main dimension). Conversely, we found mixed effects of the frame on the following sub-dimensions: reliability, trust, protection, safety, and confidence. Taken together, we show that it is possible to influence, to some extent, university students' attitudes and perceptions toward COVID-19 vaccination by acting on how information is framed. We discuss the implications of these findings for the development of behaviorally informed policies.

A National Communication Effort Addressing Maternal Mortality in the United States: Implementation of the Hear Her Campaign

More than 700 women die each year in the United States from complications related to pregnancy, and considerable racial and ethnic disparities continue to exist. Recognizing the urgent maternal warning signs of pregnancy-related complications, getting an accurate and timely diagnosis and quality care can save lives. In August 2020, the Centers for Disease Control and Prevention, Division of Reproductive Health launched a national communication campaign called "Hear Her" to raise awareness of urgent maternal warning signs during pregnancy and in the year after pregnancy and improve communication between pregnant or postpartum people and their support systems and health care providers. Storytelling is a central strategy to the campaign, which features video stories of women's experiences with pregnancy-related conditions to bring voices to the statistics and to help motivate action. These stories and additional campaign resources are disseminated through a website, digital media, organic (free) and paid social media, earned media, public service announcement distribution, and partners, with increased outreach to disproportionately affected communities. Partners in maternal and child health played an important role from campaign development to outreach and message dissemination. In the first year of the campaign, there were >390,000 unique visitors to the Hear Her website and 180 million impressions (number of times that content was displayed to a user) from digital and social media. Digital media allowed the campaign to reach priority audiences at a time when news and social media had a number of other urgent public health messages related to the COVID-19 pandemic.

Association between WASH-Related Behaviors and Knowledge with Childhood Diarrhea in Tanzania

BACKGROUND

Diarrhea remains a major cause of morbidity and mortality among children in Tanzania. The purpose of this study was to explore associations between diarrheal disease and water, sanitation, and hygiene (WASH) related behaviors and determine care-seeking predictors for diarrheal disease.

METHODS

Data from 9996 female primary caregivers were collected as part of a larger integrated nutrition program. Logistic regression was used to measure associations between predictor and dependent variables and diarrheal and care-seeking outcomes.

RESULTS

Knowledge of the importance of handwashing after assisting a child who has defecated (OR 0.79, CI 0.72-0.87), before preparing food (OR 0.88, CI 0.80-0.97), and before feeding a child (OR 0.89, CI 0.81-0.99) were each associated with not having a child with diarrhea in the past two weeks. Fathers or male caregivers (OR 0.65, CI 0.48-0.89) were less likely to seek medical care for a child with diarrhea. No associations were found between WASH-related knowledge or behavior and seeking medical care for a child with diarrhea.

CONCLUSIONS

Findings indicate that knowledge of handwashing importance was significant in washing hands after assisting a child who has defecated, before preparing food, and prior to feeding a child. These findings demonstrate the value of parental involvement to lower morbidity and mortality among children.

"#I-Am-Engaged": Conceptualization and First Implementation of a Multi-Actor Participatory, Co-designed Social Media Campaign to Raise Italians Citizens' Engagement in Preventing the Spread of COVID-19 Virus

The COVID-19 pandemic forced health authorities around the world to introduce public health measures to contain the risks of contagion. This greatly impacted on citizens' quality of life, often raising concerns and reactance. There is an ongoing urgent need to promote and sustain behavioral changes and adherence to preventive measures. Based on the theoretical framework of the Patient Health Engagement Model and a participatory co-design process, a social media campaign aimed at improving citizens' health engagement toward behavioral change for preventing the spread of COVID-19 was promoted in Italy in the early months of the pandemic. In this paper, we describe the methodological process adopted to develop the campaign, its characteristics, and the first results-in terms of audience reach and engagement in its early implementation. The discussion of this grounded-up and citizen-centered approach to social campaign development highlights key ways of promoting learning, engaging citizens, and supporting their participation in the co-production of educational interventions for behavioral change toward preventive actions.

Development and Early Implementation of a Public Communication Campaign to Help Adults to Support Children and Adolescents to Cope With Coronavirus-Related Emotions: A Community Case Study

Epidemics and pandemics can traumatically impact the emotional wellbeing of adults, children, and adolescents in diverse ways. This impact can be reduced by applying a range of evidence-based coping strategies. Based on previous research, we created a pamphlet-based communication campaign designed to assist adults to provide support for young people confronted with emotional distress associated with the pandemic caused by the novel coronavirus [severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)] and the related disease [coronavirus disease (COVID-19)] in 2020. We developed a pamphlet describing the common emotions children and adolescents report feeling in the face of disasters and the coping strategies that have proven effective in mitigating them. The target population was adults who interact with children and adolescents in both formal and informal settings. The pamphlet included basic information on this specific emergency, emotions that might be commonly experienced, and coping strategies for dealing with negative emotions. The aim of this paper is to describe the planning, development, and implementation of the campaign. First, we monitored how the media gave visibility to the campaign during the 40 days following the release of the pamphlet: it potentially reached a large audience at a national and international level through at least 216 media channels included the HEMOT^® (Helmet for EMOTions) website. Second, Google Analytics™ data from the HEMOT^® website enabled us to examine the characteristics of the visitors to the website and the behavior of those who viewed the pamphlet. More than 6,000 visitors, most from Europe followed by the Americas, visited the website in the first 40 days after the pamphlet publication. The webpage including the pamphlet obtained over 6,200 views, most directly or via other websites. A cluster analysis suggested that the access to the webpage did not mirror the trend concerning the new cases of COVID-19 in Italy (which increased during the central phase of the campaign) or worldwide (which continued to increase across the 40 days). Third, data gathered with a convenience sample of adults who had consulted the pamphlet provided a perspective on the comprehensibility of the messages conveyed by the pamphlet and on the utility for children and adolescents. The process we have demonstrated in this example could be replicated in different communities and settings to respond to the spread of the COVID-19 or to respond to other widespread or more localized disasters.

Evaluation of a Health Communication Campaign to Improve Mosquito Awareness and Prevention Practices in Western Australia

Fight the Bite represents the Department of Health's first attempt to actively raise awareness and improve prevention practices related to mosquitoes in Western Australia (WA). The multi-faceted campaign model involved a range of stakeholders and delivery methods over a 2 year period, achieving a recall rate of 8.2% among 2,500 survey participants. Significant regional differences were noted in campaign exposure, reflecting the variation in mosquito management issues throughout the State, and subsequent engagement by local government. Of those individuals with campaign recall, 43.8% reported an increase in awareness and 27.4% reported a change in behavior, which equated to a 1.7 and 1.2% change across the total survey population, respectively. The results of this study demonstrate that Fight the Bite has significantly improved awareness and prevention practices among those individuals who were exposed to the campaign. This was particularly promising, given the modest budget, resources, and time period over which the campaign was run prior to evaluation. This outcome means that Fight the Bite can be confidently adopted as a proven and standardized but regionally adaptable campaign approach to raising awareness about mosquito avoidance and mosquito-borne diseases by the Department of Health and its stakeholders. Future campaign aims include increasing reach through heightened and sustained promotion of Fight the Bite by both the Department and local government, as well as expanded collaboration with a range of stakeholders within the community.

Comparison of Two Successive Earthquake Awareness Campaigns in Israel: Improved Methodology or a Cumulative Effect?

OBJECTIVES

An effective way to reduce casualties from earthquakes is to increase population preparedness. During 2011 to 2013, Israeli authorities executed 3 national-level earthquake awareness campaigns. We aimed to assess the impact of these campaigns on the populace and the ability of the campaigns to produce a cumulative effect throughout the study period.

METHODS

Two surveys were conducted 2 weeks after the end of the first campaign and the third campaign in a similar randomly selected representative sample.

RESULTS

Exposure to the campaign proved to be a significant factor in increasing the knowledge of the respondents, giving a knowledge advantage of 1.5 times to respondents exposed to the campaign. However, the period of assessment proved to be an even more significant factor, with knowledge in 2013 being 2.3 times that in 2011. Additionally, a gap of up to 40% between the levels of trust and the perceived responsibility of respective authorities in the times of earthquake was found.

CONCLUSIONS

This study found an improvement in public knowledge regarding earthquake preparedness over the 3 years of the study. This may mean that an awareness campaign does not stand by itself, but should be part of an integrated long-term process in order to have a lasting effect on the population.

Reducing STD/HIV stigmatizing attitudes through community popular opinion leaders in Chinese markets

Reducing STDs and HIV/AIDS incidence requires campaigns designed to change knowledge, attitudes and practices of risky sexual behavior and its consequences. In China, a significant obstacle to such changes is the stigma associated with these diseases. Thus one campaign intervention strategy is to train credible community popular opinion leaders to discuss these issues in everyday social venues. This study tested the effectiveness of such an approach on reducing HIV/AIDS stigma, across two years, from a sample of over 4500 market vendors, in three conditions. Results showed an increasing growth in market communication about intervention messages, and concomitant declines in stigmatizing attitudes, across time, with the greatest changes in community popular opinion leaders, significant changes in intervention non-opinion leaders, and little change in the control markets.