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.
The Internet provides a new modality for health communication by facilitating the creation of virtual communities. These communities have the potential to influence health behavior beyond traditional FTF support groups. This study utilized content analysis of 1,424 e-mail messages posted to 2 online cancer communities to examine uses of these groups. Findings revealed (a) similarities in the content of communication in the 2 virtual communities, (b) gender differences in participation, and (c) differences in utilization of these online groups between patients and family members. These results are discussed in light of the diverse uses of online cancer communities that they reveal, the role of family members in support seeking and provision, and gender communication styles in health computer-mediated communication.
One of the major challenges facing those working with people living with HIV (PLWH) is the increased potential for burnout, which results in increased turnover and reduces quality of care provided for PLWH. The goal of this study was to examine the relationship among HIV health-care providers' burnout (emotional exhaustion and depersonalization) and organizational culture including teamwork, involvement in decision-making, and critical appraisal. Health-care providers for PLWH (N = 47) in federally funded clinics in a southwestern state completed a cross-sectional survey questionnaire about their perceptions of organizational culture and burnout. The results of multiple regression analysis indicated that positive organizational culture (i.e., teamwork) was negatively related to emotional burnout (p < .005, R2 = .18). Further negative organizational culture (i.e., critical appraisal) was positively related to depersonalization (p < .005, R2 = .18). These findings suggest that effective organizational communication interventions might protect HIV health-care providers from burnout.
Background: Theoretically designed mobile health (mHealth) breast cancer interventions are essential for achieving positive behavior change. In the case of breast cancer, they can improve the health outcomes of millions of women by increasing prevention and care efforts. However, little is known about the theoretical underpinnings of breast cancer apps available to the general public. Objective: Given that theories may strengthen mHealth interventions, this study aimed to identify breast cancer apps designed to support behavior change, to assess the extent to which they address content along the cancer care continuum and contain behavior change techniques, and to assess the degree to which star rating is related to theory-based design. Methods: Using a criteria-based screening process, we searched 2 major app stores for breast cancer apps designed to promote behavior change. Apps were coded for content along the cancer care continuum and analyzed for behavior change techniques. The Mann-Whitney U test was used to examine the relationship between star ratings and the use of behavior change techniques in apps with star ratings compared to those without ratings. Results: The search resulted in a total of 302 apps, of which 133 were identified as containing breast cancer content. Only 9.9% (30/302) of apps supported behavior change and were further analyzed. These apps were disproportionally focused on behaviors to enhance early detection, whereas only a few apps supported care management, treatment, and posttreatment behaviors. Regarding theories, 63% (19/30) of apps customized content to users, 70% (21/30) established a health-behavior link, and 80% (24/30) provided behavior change instructions. Of the 30 apps, 15 (50%) prompted intention formation whereas less than half of the apps included goal setting (9/30, 30%) and goal reviewing (7/30, 23%). Most apps did not provide information on peer behavior (7/30, 23%) or allow for social comparison (6/30, 20%). None of the apps mobilized social norms. Only half of the apps (15/30, 50%) were user rated. The results of the Mann-Whitney U test showed that apps with star ratings contained significantly more behavior change techniques (median 6.00) than apps without ratings. The analysis of behavior change techniques used in apps revealed their shortcomings in the use of goal setting and social influence features. Conclusions: Our findings indicate that commercially available breast cancer apps have not yet fully realized their potential to promote behavior change, with only a minority of apps focusing on behavior change, and even fewer including theoretical design to support behavior change along the cancer care continuum. These shortcomings are likely limiting the effectiveness of apps and their ability to improve public health. More attention needs to be paid to the involvement of professionals in app development and adherence to theories and best practices in app design to support individuals along the cancer care continuum.