Instagram Influencers in Health Communication: Examining the Roles of Influencer Tier and Message Construal in COVID-19-Prevention Public Service Announcements

This study evaluates the efficacy of social media influencer endorsements for COVID-19-prevention public service announcements (PSAs) on Instagram and its underlying mechanisms. An online experiment (N = 239) tested how influencer tier (mega-influencer versus nano-influencer) and message construal (independent versus interdependent versus collective) of the PSA influenced individuals' attitudes toward the PSA and their behavioral intentions regarding COVID-19 prevention. Participants perceived mega-influencers and nano-influencers to possess similar expertise, trustworthiness, and attractiveness. However, participants regarded nano-influencers to possess greater homophily than mega-influencers. Participants exposed to a nano-influencer's PSA displayed greater intention to engage in COVID-19 prevention behaviors than those exposed to a mega-influencer's PSA. Participants' perceived homophily with the nano-influencer also mediated its effect on participants' attitudes toward the PSA and behavioral intentions regarding COVID-19 prevention. In addition, participants evaluated the PSA with collective message construal more favorably than the PSA with independent message construal. Theoretical contributions, managerial implications, and directions for future research are provided. © 2022 American Academy of Advertising.

Instagram Influencers in Health Communication: Examining the Roles of Influencer Tier and Message Construal in COVID-19-Prevention Public Service Announcements

This study evaluates the efficacy of social media influencer endorsements for COVID-19-prevention public service announcements (PSAs) on Instagram and its underlying mechanisms. An online experiment (N = 239) tested how influencer tier (mega-influencer versus nano-influencer) and message construal (independent versus interdependent versus collective) of the PSA influenced individuals’ attitudes toward the PSA and their behavioral intentions regarding COVID-19 prevention. Participants perceived mega-influencers and nano-influencers to possess similar expertise, trustworthiness, and attractiveness. However, participants regarded nano-influencers to possess greater homophily than mega-influencers. Participants exposed to a nano-influencer’s PSA displayed greater intention to engage in COVID-19 prevention behaviors than those exposed to a mega-influencer’s PSA. Participants’ perceived homophily with the nano-influencer also mediated its effect on participants’ attitudes toward the PSA and behavioral intentions regarding COVID-19 prevention. In addition, participants evaluated the PSA with collective message construal more favorably than the PSA with independent message construal. Theoretical contributions, managerial implications, and directions for future research are provided. © 2022 American Academy of Advertising.

Cardiac Computed Tomography to Exclude Left Atrial Appendage Thrombus in Atrial Arrhythmias Prior to Direct Current Cardioversion During COVID-19 Pandemic

Background: Transoesophegeal echocardiogram (TOE) is the gold standard imaging modality to evaluate the left atrial appendage (LAA) prior to direct current cardioversion (DCCV) for atrial arrhythmia. TOE is an aerosol generating procedure, with the potential for transmission of COVID-19 infection. This study describes our experience of utilising cardiac computed tomography (CT) as an alternative imaging modality, to exclude LAA thrombus prior to DCCV in patients with atrial arrhythmias at Middlemore Hospital from 1st September 2020 until 30th September 2021 during the COVID-19 pandemic. Method: Patients with atrial arrhythmia requiring DCCV who underwent cardiac CT were identified from ANZACS-QI linked cardiac CT registry database. Patients without thrombus on cardiac CT proceeded to DCCV. Patients with slow flow or thrombus in the left atrium (LA) or LAA on CT were considered for TOE. Results: Eighty-five cardiac CT scans were performed in eighty patients (male 68.8%, mean age 59.3±14 years, body mass index 33.4±8). Sixty-seven patients (87%) had no LAA thrombus, and 65 patients proceeded safely to DCCV with no periprocedural stroke. Thirteen patients (16%) had slow flow or possible thrombus in the LA or LAA and one patient had definite thrombus. Six patients with slow flow or possible thrombus underwent TOE none had LA or LAA thrombus. Conclusion: In the majority of patients with atrial arrhythmia requiring DCCV, cardiac CT is a safe and useful alternative to TOE.

PERFORMANCE OF PUBLIC AND PRIVATE SPECIALIST MENTAL HEALTH SERVICES DURING THE PANDEMIC

Background: Public and private specialised mental health services are necessary and complementary for addressing the population mental health needs of the COVID-19 pandemic. Objectives: To provide an overview of the performance of public and private specialised mental health services. Methods: Descriptive analysis of the process and performance indicators of public and private specialised mental health services during the pandemic, drawing upon publicly available national datasets, such as those available from the Australian Institute of Health and Welfare and Private Psychiatric Hospital Database and Reporting Service. Findings: There was a relative steadiness of demand and sustainable performance for public sector specialised mental health services, while there was a relative increase in demand and performance for analogous private sector services. Conclusions: Public and private specialised mental health services are necessary and complementary for addressing the population mental health needs of the COVID-19 pandemic.

WHAT IS THE VALUE OF PRIVATE PSYCHIATRIC CARE IN AUSTRALIA?

Background: In the context of the formation of the Honeysuckle Health-NIB private health insurer (PHI) buying group that portends managed-care, as well as the increased COVID-19 provision of private psychiatric outpatient care and ongoing private psychiatric hospital care, the value of private psychiatric care is considered. Objectives: To provide an overview of the process and outcome measures of Australian private psychiatric outpatient and inpatient care, and the mental health (MH) policy, planning and implications thereof. Methods: A summary of descriptive analyses of the publicly available data sets including, but not limited to, those available from the Services Australia Medicare Item Reports, Australian Private Hospitals Association, Australian Institute of Health and Welfare, and the Australian Mental Health Outcomes and Classification Network. Findings: Substantial process data exist demonstrating that private psychiatrists provided increased levels of private psychiatric outpatient consultation during the COVID-19 pandemic. However, outcome measure data are needed for outpatient consultations. Private psychiatric hospitals process and outcome data demonstrate that such hospitals provide effective psychiatric care for primarily major affective and related mood disorders, and alcohol and other substance use disorders, with similar outcome quality to acute public sector hospitals. Conclusion: Private psychiatrists in Australia provide flexible, substantial and effective psychiatric care. Future research should focus on uniform minimum data sets, especially outcome measures, across public and private sectors to facilitate comparisons, and understand gaps in care. Health economic and needs analyses are also needed to complete estimation of care value.

PRIVATE PSYCHIATRY AND THE PANDEMIC: PROVIDING CONTINUITY OF EXPERT CARE DURING CHALLENGING TIMES

Background: Private psychiatrists flexibly adapted to provide ongoing outpatient and hospital care of patients during the COVID-19 pandemic. Objectives: To provide an overview of the Australian private psychiatric outpatient and inpatient care during the COVID-19 pandemic and discuss the implications for mental health policy and planning. Methods: Descriptive analyses of the publicly available datasets including: Services Australia Medicare Item Reports, Australian Private Hospitals Association, Australian Institute of Health and Welfare, and the Australian Mental Health Outcomes and Classification Network. Findings: Private psychiatrists provided increased levels of private psychiatric outpatient consultation during the COVID-19 pandemic, using telehealth effectively to address increased demand. Private psychiatric hospitals process and outcome data demonstrate that such hospitals provided effective psychiatric care, with similar outcome quality to acute public sector hospitals. Conclusion: Private psychiatrists in Australia provided adaptable and effective outpatient and hospital care during the COVID-19 pandemic. Innovations in telehealth will likely be useful for future pandemics, as well as increasing accessibility of care.

PANDEMIC POPULATION MENTAL HEALTH: PAST, PRESENT AND FUTURE

Background: The challenges of the COVID-19 pandemic have dominated Australian healthcare. Counter-intuitively, despite baseline workforce, infrastructure and access problems, population mental health and mental health services have weathered the first two years of the pandemic. However, there remain especially vulnerable sub-populations. Objectives: To provide a clinical update for psychiatrists and trainees on specific aspects of population mental health and mental health service performance during the COVID-19 pandemic. Methods: We review the relevant research and policy data. Conclusions: COVID-19 pandemic population mental health policy research and analysis is essential to improve clinical care and will be needed for future pandemics. The establishment of clinical registries for population mental health data can help guide future pandemic mental health policy, planning and intervention.