Evidence-based Health Communication Research Articles

Evidence-Based Health Communication in Practice: Driving Funding, Research, and Training Through the University of Texas at Austin Center for Health Communication

ABSTRACT Academic centers play a vital role in advancing knowledge, driving innovation, and fostering collaboration. The University of Texas at Austin Center for Health Communication was established in 2014 with the mission to improve public health through evidence-based communication research and practice. In this article, we reflect on the center history, explain our practice-oriented funding structure, and showcase examples of public health campaigns informed by theory and data, as well as professional-oriented educational programs. We also discuss the academic and community impact of our research, education, and practice and the benefits and challenges associated with this practice-led funding model. Although there are other approaches to operating academic centers, we hope the lessons we have learned can be of help to other centers dedicated to health communication research and practice.

“Influencing the influencers:” a field experimental approach to promoting effective mental health communication on TikTok

A substantial body of social scientific research considers the negative mental health consequences of social media use on TikTok. Fewer, however, consider the potentially positive impact that mental health content creators (“influencers”) on TikTok can have to improve health outcomes; including the degree to which the platform exposes users to evidence-based mental health communication. Our novel, influencer-led approach remedies this shortcoming by attempting to change TikTok creator content-producing behavior via a large, within-subject field experiment (N = 105 creators with a reach of over 16.9 million viewers; N = 3465 unique videos). Our randomly-assigned field intervention exposed influencers on the platform to either (a) asynchronous digital (.pdf) toolkits, or (b) both toolkits and synchronous virtual training sessions that aimed to promote effective evidence-based mental health communication (relative to a control condition, exposed to neither intervention). We find that creators treated with our asynchronous toolkits—and, in some cases, those also attending synchronous training sessions—were significantly more likely to (i) feature evidence-based mental health content in their videos and (ii) generate video content related to mental health issues. Moderation analyses further reveal that these effects are not limited to only those creators with followings under 2 million users. Importantly, we also document large system-level effects of exposure to our interventions; such that TikTok videos featuring evidence-based content received over half a million additional views in the post-intervention period in the study’s treatment groups, while treatment group mental health content (in general) received over three million additional views. We conclude by discussing how simple, cost-effective, and influencer-led interventions like ours can be deployed at scale to influence mental health content on TikTok.

Predictors of COVID-19 Vaccine Acceptance: The Role of Trust and the Influence of Social Media

ABSTRACT The study discusses the predictors of COVID-19 vaccine acceptance in Romania. We implemented a national survey using an online panel (N = 1006), representative for the online population of Romania aged 18 or higher, conducted on 13–26 October, 2020, by the national pollster QUESTIA. Results show a predictive model of people’s willingness to take the COVID-19 vaccine, in which trust in the actors and institutions involved in the management of the crisis is the strongest predictor, followed by the belief in toxic or misleading narratives about vaccines and the COVID-19 pandemic, and media consumption patterns. Education is a moderator of the relationship between trust and the willingness to vaccinate. Implications for professionals in the social work fields, as well as for policy-makers are discussed. Results could be used as a starting point for developing recommendations for evidence-based health communication in the context of the COVID-19 vaccination campaign.

“We’re always an afterthought”- Designing tobacco control campaigns for dissemination with and to LGBTQ +—serving community organizations: a thematic analysis

PurposeEvidence-based health communication campaigns can support tobacco control and address tobacco-related inequities among lesbian, gay, bisexual, transgender, and queer (LGBTQ +) populations. Community organizations focused on LGBTQ + health (e.g., nonprofits, community centers, and community health centers) can be prime channels for delivering evidence-based health communication campaigns. However, it is unclear how to balance the goals of a) designing campaigns to support broad adoption/uptake and b) adaptation addressing the needs of diverse communities and contexts. As part of an effort to support “designing for dissemination,” we explored the key challenges and opportunities staff and leaders of LGBTQ + -serving community organizations encounter when adopting or adapting evidence-based health communication campaigns.MethodsA team of researchers and advisory committee members conducted this study, many of whom have lived, research, and/or practice experience with LGBTQ + health. We interviewed 22 staff members and leaders of community organizations serving LGBTQ + populations in the US in early 2021. We used a team-based, reflexive thematic analysis approach.ResultsThe findings highlight the challenges of attempting to use health communication campaigns misaligned with the assets and needs of organizations and community members. The three major themes identified were as follows: (1) available evidence-based health communication campaigns typically do not sufficiently center LGBTQ + communities, (2) negotiation regarding campaign utilization places additional burden on practitioners who have to act as “gatekeepers,” and (3) processes of using health communication campaigns often conflict with organizational efforts to engage community members in adoption and adaptation activities.ConclusionsWe offer a set of considerations to support collaborative design and dissemination of health communication campaigns to organizations serving LGBTQ + communities: (1) develop campaigns with and for LGBTQ + populations, (2) attend to the broader structural forces impacting campaign recipients, (3) support in-house testing and adaptations, and (4) increase access to granular data for community organizations.

Use of the U.S. National Poison Data System (NPDS) to Detect and Describe Potentially Harmful, Non-Traditional Behaviors Taken by Individuals to Prevent, Treat, or Cure COVID-19

Introduction:On January 19, 2020, Washington State reported the first confirmed case of COVID-19. Two years later, the Centers for Disease Control and Prevention (CDC) reported over 90 million cases across every U.S. state and territory causing more than 1 million deaths, with numbers continuing to grow. As part of the overall pandemic response, CDC, in coordination with America’s Poison Centers, conducted enhanced surveillance of National Poison Data System (NPDS) data to detect potentially harmful, non-traditional behaviors taken to prevent, treat, or cure COVID-19 to provide situational awareness and ensure CDC continues to develop effective, evidence-based health communication messages and materials.Method:Data from the fifty-five U.S. poison centers (PCs) are uploaded in near real-time to NPDS. CDC monitored several categories including cleaners and disinfectants, medications/vitamins, and behaviors such as suicide and drug use. We characterized exposures by daily call volume, age group, management site, route of exposure, and medical outcome compared to previous years. We also conducted follow-up detailed review for certain anomalies, spikes, or extreme adverse events.Results:We reported PC data to several task forces within the CDC Emergency Operations Center. The daily number of exposures increased sharply beginning in March 2020 for exposures to cleaners and disinfectants. For example, bleach exposure calls saw a 62.1% increase compared to 2019. Several medications saw spikes in calls in coordination with media coverage of certain treatments (e.g., hydroxychloroquine) throughout the pandemic.Conclusion:This data helped ensure a coordinated public health response to COVID-19 and maximized the unique role of PCs in addressing public and medical provider concerns and questions. Results led to several actions including notifications to state health departments, targeted messaging, and tailored response efforts. PCs are a valuable resource for providing guidance and advice about exposures to hazardous substances and can help reduce the burden on the healthcare system.

Improving Uptake of Cancer Genetic Risk Assessment in a Remote Tailored Risk Communication and Navigation Intervention: Large Effect Size but Room to Grow.

Cancer genetic risk assessment (CGRA) is recommended for women with ovarian cancer or high-risk breast cancer, yet fewer than 30% receive recommended genetic services, with the lowest rates among underserved populations. We hypothesized that compared with usual care (UC) and mailed targeted print (TP) education, CGRA uptake would be highest among women receiving a phone-based tailored risk counseling and navigation intervention (TCN). In this three-arm randomized trial, women with ovarian or high-risk breast cancer were recruited from statewide cancer registries in Colorado, New Jersey, and New Mexico. Participants assigned to TP received a mailed educational brochure. Participants assigned to TCN received the mailed educational brochure, an initial phone-based psychoeducational session with a health coach, a follow-up letter, and a follow-up navigation phone call. Participants' average age was 61 years, 25.4% identified as Hispanic, 5.9% identified as non-Hispanic Black, and 17.5% lived in rural areas. At 6 months, more women in TCN received CGRA (18.7%) than those in TP (3%; odds ratio, 7.4; 95% CI, 3.0 to 18.3; P < .0001) or UC (2.5%; odds ratio, 8.9; 95% CI, 3.4 to 23.5; P < .0001). There were no significant differences in CGRA uptake between TP and UC. Commonly cited barriers to genetic counseling were lack of provider referral (33.7%) and cost (26.5%), whereas anticipated difficulty coping with test results (14.0%) and cost (41.2%) were barriers for genetic testing. TCN increased CGRA uptake in a group of geographically and ethnically diverse high-risk breast and ovarian cancer survivors. Remote personalized interventions that incorporate evidence-based health communication and behavior change strategies may increase CGRA among women recruited from statewide cancer registries.

STRATEGIES TO ADDRESS COVID-19 VACCINE HESITANCY AMONG OHIO NURSING HOME STAFF

Abstract Background Nursing home staff members unvaccinated against COVID-19 pose an ongoing public health risk considering their frequent contact with older adults, a population especially vulnerable to the virus. In order to address vaccine hesitancy and foster vaccine confidence effectively among nursing home staff, evidence-based health communication strategies are necessary. Methods Using a dataset composed from three sources of Ohio nursing home data, the research questions guiding this study are as follows: 1) What is the relationship between engaging in various strategies to address vaccine hesitancy and vaccination rates among staff?; 2) Does hiring infection preventionists affect vaccination rates among staff? Multivariable linear regression techniques were used to assess all variables. Results Peer counseling and providing time off to the staff for vaccination statistically significant strategies to reduce vaccine hesitancy among staff. Compared to facilities that did not engage in peer counseling, those that did saw an average increase of 3.6% of their staff vaccinated. Compared to facilities that did not provide time off to their staff for vaccination, those that did saw an average increase of 4.2% of their staff vaccinated. Discussion: Peer counseling should be pursued as a viable strategy for fostering vaccine confidence among nursing home staff and further studied in more diverse populations. Implications for nursing home staff acceptance of facility-wide initiatives will be discussed.

What did the pandemic teach us about effective health communication? Unpacking the COVID-19 infodemic

BackgroundThe spread of unvetted scientific information about COVID-19 presents a significant challenge to public health, adding to the urgency for increased understanding of COVID-19 information-seeking preferences that will allow for the delivery of evidence-based health communication. This study examined factors associated with COVID-19 information-seeking behavior.MethodsAn online survey was conducted with US adults (N = 1800) to identify key interpersonal (e.g., friends, health care providers) and mediated (e.g., TV, social media) sources of COVID-19 information. Logistic regression models were fitted to explore correlates of information-seeking.ResultsStudy findings show that the first sought and most trusted sources of COVID-19 information had different relationships with sociodemographic characteristics, perceived discrimination, and self-efficacy. Older adults had greater odds of seeking information from print materials (e.g., newspapers and magazines) and TV first. Participants with less educational attainment and greater self-efficacy preferred interpersonal sources first, with notably less preference for mass media compared to health care providers. Those with more experiences with discrimination were more likely to seek information from friends, relatives, and co-workers. Additionally, greater self-efficacy was related to increased trust in interpersonal sources.ConclusionStudy results have implications for tailoring health communication strategies to reach specific subgroups, including those more vulnerable to severe illness from COVID-19. A set of recommendations are provided to assist in campaign development.

The Use of Five Public Health Themes in Understanding the Roles of Misinformation and Education Toward Disparities in Racial and Ethnic Distribution of COVID-19.

The distribution of coronavirus disease 2019 (COVID-19) infection across the historically marginalized populations in the United States (US) has consistently been inequitable. In addition, systemic racism and prejudice, which have existed for decades, have caused a lack of faith in public health and medical experts and have resulted in the epidemic of misinformation. To counteract the COVID-19 pandemic and widespread misinformation, the political establishment and public health experts must work collaboratively. And because they are closely associated, there had been a significant increase in the prevalence of the disease as well as a spike in the number of hospitalizations and fatalities. Public health professionals have investigated a number of epidemiological strategies to stop the spread of the virus and mitigate its effects, but false information released via various media sources has caused serious harm to a number of people. To create the framework and guidelines for protecting audiences from lies and deceit, and eradicating false information before taking root in society, it is essential to understand the types of misinformation that are being spread since the disadvantaged and uneducated communities suffer disproportionately as a result. According to studies, spreading false information could have a negative impact on a country’s health outcomes, as well as its economic and social well-being, if not immediately refuted. Public health themes, such as evidence-based programs, health communication, and health policy, among others need to be evaluated and put into action in order to prevent the dissemination of incorrect information. This review examines a number of public health themes, such as policy and evidence-based strategies that might help in the fight against misinformation that has wreaked havoc on families and communities, particularly the underserved and uninformed populations.

Leveraging Digital Tools for Health Communication and Promotion

Globally, one-third of the world’s population has difficulty searching, comprehending, and using information needed to maintain health and well-being (Van den Broucke, 2020). Empowering people to learn and practice healthy behaviors and engage in self-care is at the core of health promotion (Van den Broucke, 2020). Appropriate health communication has been vital during the COVID-19 pandemic. The pandemic impact can be alleviated by promoting healthy behaviors while using appropriate tools to publicize information in easily understood language by the public. Most health information is accessed online so digital health communication and promotion is important. Numerous digital tools are available. Electronic mail (email) is a powerful tool to engage with various audiences using electronic devices. Worldwide 3.9 billion people use email, spending up to five hours daily to check work and personal emails (SlideShare, 2019) (Statista, 2021). Emails are cost effective and directly connect the intended audience with personalized content. MailChimp is a digital tool that the Institute for Population Health (IPH), Weill Cornell Medicine-Qatar uses to disseminate credible information via email to create awareness about health-related topics. MailChimp is convenient to use with in-built templates to create visually appealing content along with the option to add unique links as required. Embedding useful links and eye-catching visuals attracts consumers to read and learn from the content. MailChimp also hosts the audience database, manages audience preferences, and facilitates scheduling/sending the newsletters. For example, the IPH ‘Stay Safe, Stay Healthy’ newsletter created on MailChimp, focuses on topics relevant to COVID-19, health, and well-being. The newsletters guide the public to navigate, and access trusted/reputable sources to adopt lifestyles appropriate for optimum health and well-being. They provide information in simple language using appealing and culturally appropriate visuals and communicate new or updated evidence as necessary. The newsletter email campaigns have garnered 111,789 opens (total times the campaign was opened by recipients) and 28,507 clicks (total times any tracked link was clicked) from March 2020-2022 (MailChimp, 2022). Reliable, evidence-based, and well-crafted health communication can facilitate behavior change, dispel fear and uncertainty, promote compliance with positive health behaviors, and disseminate reliable and succinct information (Finset, 2020). It can also help alleviate stress and feelings of ‘overwhelm’ when confronted with information overload online (Van den Broucke, 2020). Most digital tools such as MailChimp are accessible via a paid subscription. Subscription fees could be a deterrent to their use. Nevertheless, digital tools like MailChimp are an effective means to optimize emails and can contribute to health promotion by facilitating the dissemination of health-related information via email, in a timely, efficient, and effective manner.

Sexuality education for young people in Germany.Results of the 'Youth Sexuality' representative repeat survey.

The Federal Centre for Health Education (BZgA) has been conducting the ‘Youth Sexuality’ representative survey on a regular basis since 1980. This continuous monitoring generates insights into the sexual and reproductive health of young people in Germany and constitutes an important basis for evidence-based health communication.A total of N=6,032 young people between the ages of 14 and 25 participated in a combination of oral and written interviews (Computer Assisted Personal Interviews (CAPI)).As primary sources of knowledge for, adolescents state that they obtain information through school lessons (69%), personal discussions (68%), and the Internet (59%). In addition to these sources, professional gynaecological counselling and sexuality education at home are also important sources of information. To what extent trusted contact persons are available in the family depends heavily on the adolescents’ sociocultural backgrounds.Providing information and disseminating knowledge to young people in the field of sexual and reproductive health is organised intersectorally in Germany. In this way, it is possible to also reach those who do not have any contact persons at their disposal in their direct family. Maintaining and strengthening the current commitment in promoting sexual health is of key importance, as only this will ensure the next generation’s sexual and reproductive health, and provide an evidence-based counterbalance to anecdotal information, especially in the digital domain.

Characterizing discourses about COVID-19 vaccines on Twitter: a topic modeling and sentiment analysis approach

ABSTRACT Background Evidence-based health communication is crucial for facilitating vaccine-related knowledge and addressing vaccine hesitancy. To that end, it is important to understand the discourses about COVID-19 vaccination and attend to the publics’ emotions underlying those discourses. Methods We collect tweets related to COVID-19 vaccines from March 2020 to March 2021. In total, 304,292 tweets from 134,015 users are collected. We conduct a Latent Dirichlet Allocation (LDA) modeling analysis and a sentiment analysis to analyze the discourse themes and sentiments. Results This study identifies seven themes of COVID-19 vaccine-related discourses. Vaccine advocacy (24.82%) is the most widely discussed topic about COVID-19 vaccines, followed by vaccine hesitancy (22.29%), vaccine rollout (12.99%), vaccine facts (12.61%), recognition for healthcare workers (12.47%), vaccine side effects (10.07%), and vaccine policies (4.75%). Trust is the most salient emotion associated with COVID-19 vaccine discourses, followed by anticipation, fear, joy, sadness, anger, surprise, and disgust. Among the seven topics, vaccine advocacy tweets are most likely to receive likes and comments, and vaccine fact tweets are most likely to receive retweets. Conclusions When talking about vaccines, publics’ emotions are dominated by trust and anticipation, yet mixed with fear and sadness. Although tweets about vaccine hesitancy are prevalent on Twitter, those messages receive fewer likes and comments than vaccine advocacy messages. Over time, tweets about vaccine advocacy and vaccine facts become more dominant whereas tweets about vaccine hesitancy become less dominant among COVID-19 vaccine discourses, suggesting that publics become more confident about COVID-19 vaccines as they obtain more information.

The Impact of the Tips from Former Smokers® Campaign on Reducing Cigarette Smoking Relapse.

Evidence-based mass-reach health communication campaigns can increase tobacco cessation, use of cessation resources such as quitlines, and change tobacco-related social norms. These interventions have been associated with a lower likelihood of cigarette smoking relapse in studies conducted internationally; however, no studies have assessed this outcome for a national campaign in the United States. This study examined the relationship between Tips from Former Smokers® (Tips®) campaign exposure and the odds of cigarette smoking relapse among adults who formerly smoked. Using data from the 2014 to 2019 Tips longitudinal campaign surveys, we estimated first episode of relapse (versus remaining a former smoker) as a function of Tips gross rating points (GRPs, a measure of media exposure). Higher levels of Tips GRPs were associated with lower odds of relapse (aOR = 0.63, 95% CI: 0.50-0.78). These results suggest that the Tips campaign may reduce smoking relapse, in addition to the established effect of increasing smoking cessation. Former smokers can be considered a secondary target audience for smoking cessation mass media campaigns, and mass media campaigns could be considered a component of smoking relapse prevention efforts.

Assessment of COVID-19 Website Communication in Languages Other than English by Local Health Departments in the United States

ABSTRACT Managing the information needs of diverse populations through accessible, high-quality, and evidence-based health communication is critical to controlling the COVID-19 pandemic. Access to comprehensive information is especially important for the >25 million limited English proficient (LEP) individuals in the U.S. who prefer to communicate in languages other than English. We assessed the alignment of COVID-19 communication with LEP constituents’ needs by examining multilingual content availability on the health department websites of the largest U.S. cities by population. To guide content analysis, we designed a codebook to evaluate six content types, six delivery modes, and three score measures for each website; for each, we measured Holsti’s percent of agreement. We then compared the amount of information provided in all combined content types across cities and languages by delivery mode. We thematically analyzed open-ended responses about users’ experiences with each city’s webpages. We found that COVID-19 information was not presented consistently across languages: many cities provided less information among several delivery modes in other languages compared to English. We found a discrepancy in the amount of information, presentation quality, and ease of navigability of the information among languages and between cities. Users described having negative experiences with most cities’ COVID-19 websites in languages other than English. Our findings indicate a gap in the application of the cultural sensitivity approach by local health departments to address issues related to equitable multilingual, multimodal emergency communication, and underscore the need to improve guidelines for communicating public health information as a component of advancing health equity.

Predicting COVID-19 Vaccination Intention: The Roles of Institutional Trust, Perceived Vaccine Safety, and Interdependent Self-Construal

ABSTRACT The purpose of this study is to explore the process through which institutional trust influences individuals’ vaccination intentions for a coronavirus vaccine. We collected data from a national representative sample of the Spanish population (N = 500) from an online research panel to test the proposed conceptual model. Results revealed a positive association of institutional trust with coronavirus vaccination intentions. This effect was mediated by perceived vaccine safety and positive attitude toward the vaccine. Furthermore, findings corroborate the moderating effect of interdependent self-construal on the indirect relationship between institutional trust and vaccination intention, implying that this effect was stronger for individuals with higher levels of interdependent orientation. Findings have implications for the development of evidence-based health communication strategies for encouraging COVID-19 vaccination.

Shared Decision Making in Primary Care Based Depression Treatment: Communication and Decision-Making Preferences Among an Underserved Patient Population.

Objectives: Although depression is a significant public health issue, many individuals experiencing depressive symptoms are not effectively linked to treatment by their primary care provider, with underserved populations have disproportionately lower rates of engagement in depression care. Shared decision making (SDM) is an evidence-based health communication framework that can improve collaboration and optimize treatment for patients, but there is much unknown about how to translate SDM into primary care depression treatment among underserved communities. This study seeks to explore patients' experiences of SDM, and articulate communication and decision-making preferences among an underserved patient population receiving depression treatment in an urban, safety net primary care clinic.Methods: Twenty-seven patients with a depressive disorder completed a brief, quantitative survey and an in-depth semi-structured interview. Surveys measured patient demographics and their subjective experience of SDM. Qualitative interview probed for patients' communication preferences, including ideal decision-making processes around depression care. Interviews were transcribed verbatim and analyzed using thematic analysis. Univariate statistics report quantitative findings.Results: Overall qualitative and quantitative findings indicate high levels of SDM. Stigma related to depression negatively affected patients' initial attitude toward seeking treatment, and underscored the importance of patient-provider rapport. In terms of communication and decision-making preferences, patients preferred collaboration with doctors during the information sharing process, but desired control over the final, decisional outcome. Trust between patients and providers emerged as a critical precondition to effective SDM. Respondents highlighted several provider behaviors that helped facilitated such an optimal environment for SDM to occur.Conclusion: Underserved patients with depression preferred taking an active role in their depression care, but looked for providers as partner in this process. Due to the stigma of depression, effective SDM first requires primary care providers to ensure that they have created a safe and trusting environment where patients are able to discuss their depression openly.

TYPES OF CAMPAIGNS IN EVIDENCE-BASED HEALTH COMMUNICATION

Health communication is a field of study that has been included in the communication world since the 1970s. Health communication has a field of application carried out by individuals and media-mediated communication in health service delivery and health promotion. Health communication is an applied field of study because it examines both the pragmatic effects of human communication on the provision of healthcare and public health promotion and studies in this area are often used to improve the quality of healthcare delivery. Health communication campaigns are prepared to reveal desired health behaviors in society and to prevent risky health behaviors. However, whether these campaigns achieve their goals is an issue that is rarely discussed. Health communication and its applications at the mass communication level are realized through health communication campaigns. The success of a health communication campaign is measured by comparing the current situation before and after the campaign. This brings us to the concept of evidence-based health communication. This study describes the design stages of evidence-based health communication, which is an effective phenomenon in measuring campaign success. The similarities and differences among non- experimental, quasi-experimental and experimental designs were revealed in the study. The aim of the study is to explain the campaign design stages of evidence-based health communication and provide a guide to the pre-campaign preparation process for practitioners. Thus, practitioners will be able to choose the most suitable design for their target audience and avoid application mistakes.

Each post matters: a content analysis of #mentalhealth images on Instagram

This study examined mental health-related content on a popular visual-based social media platform, Instagram. A content analysis was completed by using the search term ‘#mentalhealth’ on public Instagram posts (N = 758). Our data showed that wellness practices related to mental health (e.g. exercise, healthy eating), anxiety, and depression are the most addressed mental health topics on Instagram. Additionally, posts that mention at least one type of mental health problem seek peer support and engagement from other users at a higher rate compared to posts that do not mention mental health disorder or topic (beyond the search term #mentalhealth). We discussed these findings in detail, as well as their theoretical and practical implications and the limitations of this study. We also suggested avenues for further research to promote evidence-based health communication techniques tailored to current visual-based social media platforms.

How Fear Appeal Approaches in COVID-19 Health Communication May Be Harming the Global Community.

As health professionals develop health communication for coronavirus disease 2019 (COVID-19), we implore that these communication approaches do not include fear appeals. Fear appeals, also known as scare tactics, have been widely used to promote recommended preventive behaviors. We contend that unintended negative outcomes can result from fear appeals that intensify the already complex pandemic and efforts to contain it. We encourage public health professionals to reevaluate their desire to use fear appeals in COVID-19 health communication and recommend that evidence-based health communication be utilized to address the needs of a specific community, help people understand what they are being asked to do, explain step-by-step how to complete preventative behaviors, and consider external factors needed to support the uptake of behaviors. To aid health professionals in redirecting away from the use of fear appeals, we offer a phased approach to creating health communication messages during the COVID-19 crisis.

A Software Tool Aimed at Automating the Generation, Distribution, and Assessment of Social Media Messages for Health Promotion and Education Research.

BackgroundSocial media offers promise for communicating the risks and health effects of harmful products and behaviors to larger and hard-to-reach segments of the population. Nearly 70% of US adults use some social media. However, rigorous research across different social media is vital to establish successful evidence-based health communication strategies that meet the requirements of the evolving digital landscape and the needs of diverse populations.ObjectiveThe aim of this study was to expand and test a software tool (Trial Promoter) to support health promotion and education research by automating aspects of the generation, distribution, and assessment of large numbers of social media health messages and user comments.MethodsThe tool supports 6 functions (1) data import, (2) message generation deploying randomization techniques, (3) message distribution, (4) import and analysis of message comments, (5) collection and display of message performance data, and (6) reporting based on a predetermined data dictionary. The tool was built using 3 open-source software products: PostgreSQL, Ruby on Rails, and Semantic UI. To test the tool’s utility and reliability, we developed parameterized message templates (N=102) based upon 2 government-sponsored health education campaigns, extracted images from these campaigns and a free stock photo platform (N=315), and topic-related hashtags (N=4) from Twitter. We conducted a functional correctness analysis of the generated social media messages to assess the algorithm’s ability to produce the expected output for each input. We defined 100% correctness as use of the message template text and substitution of 3 message parameters (ie, image, hashtag, and destination URL) without any error. The percent correct was calculated to determine the probability with which the tool generates accurate messages.ResultsThe tool generated, distributed, and assessed 1275 social media health messages over 85 days (April 19 to July 12, 2017). It correctly used the message template text and substituted the message parameters 100% (1275/1275) of the time as verified by human reviewers and a custom algorithm using text search and attribute-matching techniques.ConclusionsA software tool can effectively support the generation, distribution, and assessment of hundreds of health promotion messages and user comments across different social media with the highest degree of functional correctness and minimal human interaction. The tool has the potential to support social media–enabled health promotion research and practice: first, by enabling the assessment of large numbers of messages to develop evidence-based health communication, and second, by providing public health organizations with a tool to increase their output of health education messages and manage user comments. We call on readers to use and develop the tool and to contribute to evidence-based communication methods in the digital age.