Mental distress and virtual mental health resource use amid the COVID-19 pandemic: Findings from a cross-sectional study in Canada.

Objective: This paper characterizes levels of mental distress among adults living in Canada amid the COVID-19 pandemic and examines the extent of virtual mental health resource use, including reasons for non-use, among adults with moderate to severe distress. Methods: Data are drawn from a cross-sectional monitoring survey (29 November to 7 December 2021) on the mental health of adults (N = 3030) in Canada during the pandemic. Levels of mental distress were assessed using the Kessler Psychological Distress Scale. Descriptive statistics were used to examine virtual mental health resource use among participants with moderate to severe distress, including self-reported reasons for non-use. Results: Levels of mental distress were classified as none to low (48.8% of participants), moderate (36.6%), and severe (14.6%). Virtual mental health resource use was endorsed by 14.2% of participants with moderate distress and 32% of those with severe distress. Participants with moderate to severe distress reported a range of reasons for not using virtual mental health resources, including not feeling as though they needed help (37.4%), not thinking the supports would be helpful (26.2%), and preferring in-person supports (23.4%), among other reasons. Conclusions: This study identified a high burden of mental distress among adults in Canada during the COVID-19 pandemic alongside an apparent mismatch between actual and perceived need for support, including through virtual mental health resources. Findings on virtual mental health resource use, and reasons for non-use, offer directions for mental health promotion and health communication related to mental health literacy and the awareness and appropriateness of virtual mental health resources.

A critical review of health marketing in Zimbabwe during COVID-19

The coronavirus befell the world in late 2019 resulting in the World Health Organisation declaring a global pandemic in March 2020. As governments and health authorities around the world struggled to control the pandemic, key components of their efforts include the publicizing of their services, informing citizens of good hygiene practices, keeping the nation informed of the spread of the virus and generally keeping citizens in a positive and focused frame of mind. These efforts fall within the definition of health marketing which applies marketing principles and theories combined with health strategies to promote people's health. These efforts also draw on both traditional and new digital channels, including online and social media, to carry across the health-marketing message to citizens. Zimbabwe is no different. The Ministry of Health and Child Care in Zimbabwe is the public authority responsible for healthcare in the country. This study reviews the three main digital channels used by the Ministry to communicate with Zimbabwean citizens, namely, their website, Facebook and Twitter. The review involves a longitudinal dissection of the communications shared across these three channels for the period from May to August 2020 and uses both content and thematic analysis to understand and critique the health communications being put out by the Ministry to its citizens. The review also takes into consideration the public comments on these communications to present a critical review of the effectiveness of these communications from a health-marketing perspective. The findings provide useful insight into the positive aspects and shortcomings of these communications and contribute to a conceptual framework for managing health-marketing communications in a time of crisis. © 2023 Intellect Ltd.

The Analysis of the Context of Digital Access to Healthcare in Russia

Digital accessibility is one of the key principles of modern healthcare. The Internet has become a main tool to both communicate and engage patients. This study aims to analyze adults' preferences on health information resources and the utilization of digital healthcare tools in Russia. The data were collected from the online survey conducted in August-September 2020. The association of factors with individual preferences was analyzed using Pearson's χ2 with Holm–Bonferroni correction. The sample included 1319 respondents' submissions. The most prioritized activity on the Internet among all the respondents was social media 64.1% (95% CI 61.4–66.6%). Females, those who are more educated, and more active Internet users were more likely to use all available sources to gather health information. Almost one-half of the respondents (48.0%;95% CI 45.3–50.7%) reported that they did not use any digital tools to manage their medical appointments. Smartphones were more likely to be used by younger and more active Internet users, while personal computers were prioritized as the preferable device to access the Internet by males and older adults. The study revealed that both public health authorities and health providers must provide a wider range of information and digital interaction experiences appropriate to the needs and preferences of patients.

Factors Affecting SARS-CoV-2 Vaccination Intent and Decision Making Among African American, Native American, and Hispanic Participants in a Qualitative Study.

Limited studies are available on how decisions and perceptions on SARS-CoV-2 vaccination have changed since the start of vaccination availability. We performed a qualitative study to identify factors critical to SARS-CoV-2 vaccination decision making and how perspectives evolved among African American/Black, Native American, and Hispanic communities disproportionately affected by COVID-19 and social and economic disadvantage. We conducted 16 virtual meetings, with 232 participants in wave 1 meetings (December 2020) and with 206 returning participants in wave 2 meetings (January and February 2021). Wave 1 vaccine concerns in all communities included information needs, vaccine safety, and speed of vaccine development. Lack of trust in government and the pharmaceutical industry was influential, particularly among African American/Black and Native American participants. Participants showed more willingness to get vaccinated at wave 2 than at wave 1, indicating that many of their information needs had been addressed. Hesitancy remained greater among African American/Black and Native American participants than among Hispanic participants. Participants in all groups indicated that conversations tailored to their community and with those most trustworthy to them would be helpful. To overcome vaccine hesitancy, we propose a model of fully considered SARS-CoV-2 vaccine decision making, whereby public health departments supply information, align with community values and recognize lived experiences, offer support for decision making, and make vaccination easy and convenient.

Prevalence and Correlates of COVID-19 Vaccine Information on Family Medicine Practices' Websites in the United States: Cross-sectional Website Content Analysis.

BACKGROUND: Primary care providers are regarded as trustworthy sources of information about COVID-19 vaccines. Although primary care practices often provide information about common medical and public health topics on their practice websites, little is known about whether they also provide information about COVID-19 vaccines on their practice websites. OBJECTIVE: This study aimed to investigate the prevalence and correlates of COVID-19 vaccine information on family medicine practices' website home pages in the United States. METHODS: We used the Centers for Medicare and Medicaid National Provider Identifier records to create a sampling frame of all family medicine providers based in the United States, from which we constructed a nationally representative random sample of 964 family medicine providers. Between September 20 and October 8, 2021, we manually examined the practice websites of these providers and extracted data on the availability of COVID-19 vaccine information, and we implemented a 10% cross-review quality control measure to resolve discordances in data abstraction. We estimated the prevalence of COVID-19 vaccine information on practice websites and website home pages and used Poisson regression with robust error variances to estimate crude and adjusted prevalence ratios for correlates of COVID-19 vaccine information, including practice size, practice region, university affiliation, and presence of information about seasonal influenza vaccines. Additionally, we performed sensitivity analyses to account for multiple comparisons. RESULTS: Of the 964 included family medicine practices, most (n=509, 52.8%) had ≥10 distinct locations, were unaffiliated with a university (n=838, 87.2%), and mentioned seasonal influenza vaccines on their websites (n=540, 56.1%). In total, 550 (57.1%) practices mentioned COVID-19 vaccines on their practices' website home page, specifically, and 726 (75.3%) mentioned COVID-19 vaccines anywhere on their practice website. As practice size increased, the likelihood of finding COVID-19 vaccine information on the home page increased (n=66, 27.7% among single-location practices, n=114, 52.5% among practices with 2-9 locations, n=66, 56.4% among practices with 10-19 locations, and n=304, 77.6% among practices with 20 or more locations, P<.001 for trend). Compared to clinics in the Northeast, those in the West and Midwest United States had a similar prevalence of COVID-19 vaccine information on website home pages, but clinics in the south had a lower prevalence (adjusted prevalence ratio 0.8, 95% CI 0.7 to 1.0; P=.02). Our results were largely unchanged in sensitivity analyses accounting for multiple comparisons. CONCLUSIONS: Given the ongoing COVID-19 pandemic, primary care practitioners who promote and provide vaccines should strongly consider utilizing their existing practice websites to share COVID-19 vaccine information. These existing platforms have the potential to serve as an extension of providers' influence on established and prospective patients who search the internet for information about COVID-19 vaccines.

Impact of COVID-19 response on public health literacy and communication.

With unaddressed challenges of pandemic with re-emergence of coronavirus disease 2019 (COVID-19) waves, public health literacy and communication have proved to be a prerequisite for effective communication as part of the control strategy. Hence this article addressed the impact of COVID-19 response policies on public health literacy. Considering the rapid transmission of COVID-19, taking lives needs urgent attention from the population>s perspective to be more vigilant about health information and incorporate that into their daily routines. To be responsible and resilient globally, governments and states are formulating different health policies and related plans to prevent and control the spread of the pandemic. This article has recommended short-term measures, including smart focused IEC targeted on vaccination and motivational sessions for health care workers and front line workers. Targeted Long-term measures included healthcare system reforms inclusive of resources, workforce, capacity building with particular focus on lifestyle measures addressing non-communicable disease prevention.

Perceptions of risk in people with inflammatory arthritis during the COVID-19 pandemic.

Objective: People with inflammatory arthritis have an increased incidence of serious illness and mortality, placing them at risk of poor outcomes from coronavirus disease 2019 (COVID-19). This study explored patients' perceptions of risk from COVID-19 over a longitudinal period of the pandemic. Methods: Fifteen adults with inflammatory arthritis attending a National Health Service rheumatology service each took part in three semi-structured telephone interviews conducted between 16 September 2020 and 29 July 2021. Interpretive phenomenological analysis was undertaken by two researchers and two public contributors. Results: Four main themes relating to perceptions of risk from COVID-19 were identified: inflammatory arthritis; medications and co-morbidities; immediate social environment; health policy communication; and media influence. Participants recognized that having inflammatory arthritis increased their individual risk. Perceptions of risk and associated fear increased during the pandemic, influenced by family/friends who had had COVID-19 and health policy communications. The perceived constant use of negative messages led to many participants disengaging with the media. At the final interviews, when the vaccination programme was well established, participants continued to assess the risk and benefits of engaging in activities. Conclusion: This study demonstrates the breadth of factors that influenced perceptions of risk in people with an inflammatory arthritis. As health professionals, we have only a small sphere of influence over some of these factors, namely health-care communications. People with inflammatory arthritis appropriately knew that their condition increased their infection risk, but more could be done to consider how and to what extent we involve patients in explaining risk at times of crisis.

Cyber-attacks are a permanent and substantial threat to health systems: Education must reflect that.

Cyber-attacks on healthcare institutions have increased in recent years and have made headlines through the COVID-19 pandemic. With the fallout of attacks increasingly reported in academic research and in the media, there is a real urgency to address cyber-threats that must be augmented across and within health systems. Until now, clinical healthcare professionals have considered cyber-attacks on healthcare organisations a predominantly information and communication technology issue, but this perception is no longer fit-for-purpose. This commentary provides insights into the scale of cyber-attacks and their impact on staff wellbeing, arguing that cybersecurity education for all staff in healthcare organisations must be improved through online resources, simulation, and gaming. The role of national educators, policymakers, and multilateral organisations in achieving this is outlined alongside implications for future policy and practice.

Motivate me to exercise with you: The effects of social media fitness influencers on users' intentions to engage in physical activity and the role of user gender.

Objective: Social media fitness influencers are evolving into a new digital form of health communicators whom consumers might turn to for assistance with more physical activity and exercise at home, especially in the current COVID-19 crisis. Drawing from source credibility theory, social cognitive theory, protection motivation theory and literature on physical activity, physical fitness and gender, we analyse how male and female users' evaluations of social media fitness influencers and user health-related variables impact intentions to exercise with the social media fitness influencer. Methods: Two consecutive studies using male and female YouTube fitness influencers were carried out. Structural equation modelling was conducted to test the proposed models and estimate the path coefficients. Results: Study 1 (N = 507) shows that the respective influencer's perceived trustworthiness, expertise and attractiveness are important for the influencer's evaluation, and that it is the perceived motivating power rather than the attitude toward the influencer that increases intentions to exercise for male and female users. Study 2 (N = 445) extends Study 1 and shows that physical fitness, training involvement with YouTube fitness videos and lower health increase behavioural intentions. A more negative body image also raises intentions to exercise, but only among female users. Conclusion: Social media fitness influencers who are perceived as trustworthy, as experts and as attractive, can be effective for increasing men's and women's physical activity. Perceived motivating power of the influencer emerged as a key variable that predicts intentions to exercise. User health-related variables have different effects on intentions to exercise for men and women.

Loneliness Among Rural Self-Management Education Program Enrollees During the COVID-19 Pandemic.

PURPOSE: Pandemic-related isolation may exacerbate loneliness among rural adults; we sought to characterize loneliness and associated factors among rural adults during the COVID-19 pandemic. DESIGN: Cross-sectional observational study. SETTING: Remotely delivered self-management education (SME) workshops, rural upstate New York, May-December 2020. SUBJECTS: Rural SME workshop enrollees, aged 18+, n = 229. MEASURES: De Jong Gierveld 6-Item Loneliness Scale, sociodemographics, workshop type (chronic disease, chronic pain, diabetes), delivery mode (videoconference, phone, self-study); data collected via workshop process measures and enrollment surveys. ANALYSIS: Multivariable linear regression. RESULTS: Mean overall, emotional and social loneliness scores were 2.78 (SD = 1.91), 1.27 (SD = 1.02), and 1.52 (SD = 1.26). Being not married/partnered (ß = .61) and self-reported depression/anxiety (ß = .64) were associated with higher overall scores, and selection of videoconference (ß = -.77) and self-study (ß =-.85) modes with lower scores. Self-reported depression/anxiety (ß = .51) was associated with increased emotional loneliness. Being not married/not partnered (ß = .37) and selection of chronic pain workshops (ß = .64) was were associated with increased social loneliness. Selection of videoconference (ß = -.44) and self-study (ß = -.51) delivery modes were protective of social loneliness. CONCLUSION: In addition to marital status and depression/anxiety, experiencing chronic pain and selecting phone-based workshops were associated with higher degrees of loneliness among rural adults during the pandemic. The latter may be partly explained by insufficient internet access. Health educators should be prepared to address loneliness in rural areas during the pandemic.

Potential Influencers of COVID-19 Vaccine Acceptance Among Adults Living in the United States Who Have Accepted or Plan to Accept the Vaccine: An Online Survey.

PURPOSE: The purpose of this study was to 1) determine the demographic differences between adults who have accepted, or plan to accept, the COVID-19 vaccine and those who will not accept the COVID-19 vaccine and 2) describe the potential influencers in deciding to accept the COVID-19 vaccine among adults living in the United States who have accepted or plan to accept the vaccine. DESIGN: A cross-sectional design utilizing an online survey was deployed using social media and a crowdsourcing platform. SETTING: United States. SUBJECTS: One thousand three hundred ninety-five (1395) adults completed the survey. The majority were white, male, between the ages of 25 and 45, and with representation from 50 states and Puerto Rico. MEASURES: A two-branched survey was used to assess demographic information, vaccination intention, and 19 potential influencers of COVID-19 vaccine acceptance. ANALYSIS: Analysis included descriptive statistics and Chi-square tests to determine differences between groups. RESULTS: A higher proportion of male (P < .001), married (P < .001), and college-educated (P < .001) participants reported acceptance of the vaccine. The factors with the highest mean score of reported level of influence were duty to protect the vulnerable and contribution to move society back to a sense of normalcy. CONCLUSION: Understanding the potential influencers of vaccine acceptance may provide insight into strategies that could increase vaccination uptake.

Perceptions of the impact of COVID-19 on healthcare communication in a nationally representative cross-sectional survey of family caregivers.

OBJECTIVE: To understand the perceptions of the impact of the COVID-19 pandemic on healthcare communication with family caregivers. DESIGN: Nationally representative survey. SETTING: USA (national). PARTICIPANTS: 340 family caregivers, demographically representative of the US population by race/ethnicity. PRIMARY OUTCOME MEASURES: Communication outcomes (feeling involved by the provider, feeling involved by the care recipient, feeling more encouraged to be involved in care, feeling contributory to discussions, feeling questions are being answered), behavioural/wellness outcomes (feeling anxious, feeling isolated, feeling it is easier to attend the clinic visit), and desire to continue using telemedicine. RESULTS: Having less than a college degree was associated with decreased odds of feeling involved by the provider (OR 0.46; 95% CI 0.26 to 0.83; p=0.01), feeling involved by the care recipient (OR 0.44; 95% CI 0.24 to 0.79; p=0.01), feeling more encouraged to be involved in care (OR 0.49; 95% CI 0.27 to 0.86; p=0.01), feeling like they contribute to discussions (OR 0.45; 95% CI 0.25 to 0.82; p=0.01) and feeling like their questions are being answered (OR 0.33; 95% CI 0.18 to 0.60; p<0.001). CONCLUSION: In our sample, the shift to telemedicine during COVID-19 was well received but caregivers of low educational attainment reported poorer health communication, and a greater proportion of black/African American and Hispanic caregivers reported a desire to return to in-person visits. There is an opportunity to improve health systems and increase equity as telemedicine becomes more widespread.

Communications to Promote Interest and Confidence in COVID-19 Vaccines.

PURPOSE: Communicating about COVID-19 vaccine side effects and efficacy is crucial for promoting transparency and informed decision-making, but there is limited evidence on how to do so effectively. DESIGN: A within-subjects experiment. SETTING: Online survey from January 21 to February 6, 2021. SUBJECTS: 596 US Veterans and 447 non-Veterans. INTERVENTION: 5 messages about COVID-19 vaccine side effects and 4 messages about COVID-19 vaccine efficacy. MEASURES: COVID-19 vaccine interest (1 = "I definitely do NOT want the vaccine" to 7 = "I definitely WANT the vaccine" with the midpoint 4 = "Unsure"). Confidence about COVID-19 vaccine efficacy (1= "Not at all confident," 2 = "Slightly confident," 3 = "Somewhat confident," 4 = "Moderately confident," 5 = "Extremely confident"). RESULTS: Compared to providing information about side effects alone (M = 5.62 [1.87]), messages with additional information on the benefits of vaccination (M = 5.77 [1.82], P < .001, dz = .25), reframing the likelihood of side effects (M = 5.74 [1.84], P < .001, dz = .23), and emphasizing that post-vaccine symptoms indicate the vaccine is working (M = 5.72 [1.84], P < .001, dz = .17) increased vaccine interest. Compared to a vaccine efficacy message containing verbal uncertainty and an efficacy range (M = 3.97 [1.25]), messages conveying verbal certainty with an efficacy range (M = 4.00 [1.24], P = .042, dz=.08), verbal uncertainty focused on the upper efficacy limit (M = 4.03 [1.26], P < .001, dz = .13), and communicating the point estimate with certainty (M = 4.02 [1.25], P < .001, dz = .11) increased confidence. Overall, Veteran respondents were more interested (MVeterans = 5.87 [1.72] vs MNonVeterans = 5.45 [2.00], P < .001, d = .22) and confident (MVeterans = 4.13 [1.19] vs MNonVeterans = 3.84 [1.32], P < .001, d = .23) about COVID-19 vaccines than non-Veterans. CONCLUSIONS: These strategies can be implemented in large-scale communications (e.g., webpages, social media, and leaflets/posters) and can help guide healthcare professionals when discussing vaccinations in clinics to promote interest and confidence in COVID-19 vaccines.

Health Information on COVID-19 Vaccination: Readability of Online Sources and Newspapers in Singapore, Hong Kong, and the Philippines

To address the COVID-19 pandemic, as with other infectious diseases, a key intervention is vaccination. Health communications are thus of vital importance for informing the public on the benefits and risks of vaccines. This in turn makes the readability of media content fundamental. Previous studies of COVID-19-related information have found the readability of online information considerably more difficult than recommended. However, studies on the readability of information related to COVID-19 vaccination in Asian contexts have yet to be carried out. Furthermore, especially in the case of the current pandemic, health information is communicated by a variety of information channels, including the internet and mass media. This paper investigates the readability of textual information on COVID-19 vaccination found online and in newspaper articles in parts of Asia where English is one of the main languages, namely Singapore, Hong Kong, and the Philippines. Readability was assessed using a set of readability tests (Flesch–Kincaid Reading Ease, Flesch–Kincaid Grade Level, Gunning Fog Index, Coleman–Liau Index, and Simple Measure of Gobbledygook Grade level). It was found that a low proportion of URLs scored within recommended readability thresholds, and did so consistently across locations and types of sources. Furthermore, a relatively low proportion of web searches returned information from local sources;most URLs linked to sources outside of Singapore, Hong Kong, or the Philippines. Further, local online and newspaper sources scored similarly poorly on readability on average compared to non-local sources. Understanding of fast-evolving health communications concerning COVID-19 vaccination encompasses information about vaccine development and deployment from other locations, as well as locally. Nevertheless, these findings indicated a fairly low proportion of local sources among the top search results, and relatively low (i.e., difficult-to-read) readability scores for top search results and for local newspapers. An important issue for health communications strategies addressing COVID-19 vaccination will therefore be to consider different types of media sources in order to achieve the right mix of local and non-local sources while also ensuring appropriate readability.

Lessons Learned From a Qualitative COVID-19 Investigation Among Essential Workers With Limited English Proficiency in Southwest Kansas.

In this commentary, we briefly describe our methodology in conducting a remote qualitative investigation with essential workers from southwest Kansas, and then describe some key considerations, challenges, and lessons learned in recruiting and conducting interviews remotely. From August 4, 2020 through August 26, 2020, Centers for Disease Control and Prevention (CDC) staff conducted five phone interviews with culturally and linguistically diverse employees in southwest Kansas to understand COVID-19 knowledge, attitudes, and practices and communication preferences. Our experience details the potential challenges of the federal government in recruiting individuals from these communities and highlights the possibilities for more effectively engaging health department and community partners to support investigation efforts. Optimizing recruitment strategies with additional participation from community partners, developing culturally and linguistically appropriate data collection tools, and providing supportive resources and services may augment participation from refugee, immigrant, and migrant (RIM) communities in similar remote investigations.

Unpacking Cigar Product Familiarity and Terminology among Black and Hispanic Youth: It's All about Blunts.

The prevalence rate of Cigar, Little Cigar, and Cigarillo (CLCC) use among youth rose above the rate of cigarettes for the first time in 2019, and Black and Hispanic youth remain disproportionately more susceptible and likely to use these products compared to White youth. Addressing this disparity through education requires a clearer understanding of the ways youth refer to, and group, CLCCs. Twenty-eight virtual focus groups with youth ages 13-17 (n = 105) were conducted across the U.S. Groups were split by race/ethnicity, with 14 Black and 14 Hispanic groups, and further divided by CLCC experimenters and susceptible users. Youth participants discussed CLCC use behaviors, harm and risk perceptions, and knowledge, attitudes, and beliefs about CLCC products. When shown photos of CLCC products during focus groups, youth across groups identified and labeled these products into four subcategories. Large cigars were universally labeled "cigars". Little cigars were unfamiliar and guessed to be cigarettes. Tipped cigarillos were synonymous with the brand Black and Mild and considered tobacco. Untipped cigarillos were most referred to as "blunts" and used with marijuana. Understanding the nuances of language and use patterns of CLCCs is critical to ensuring the accuracy of measurement and impact of public health communications.

Receptiveness of American adults to COVID-19 vaccine boosters: A survey analysis.

Objective: This Short Communication report summarizes results from a recent survey on the willingness of American adults to accept COVID-19 vaccine boosters. We seek to identify evolving hesitancies and objections to booster shots among those who previously accepted vaccination. Methods: A representative, web-based survey of 600 adults in the State of Florida was fielded, and the results are analyzed using both descriptive and inferential statistical methods. Results: The survey responses show that while booster shot hesitancy is relatively low among vaccinated Americans, nearly a third (30.4%) say that they are only somewhat likely or less to receive a vaccine booster shot. Statistical analysis shows that trust in public health guidance is the driving factor behind booster shot hesitancy, while significant differences also exist based on race and level of education. The most frequently cited objections to booster shots include concerns over the necessity of additional shots and adverse reactions to the initial vaccination. Conclusion: Objections to booster shots highlight emerging communications challenges that health professional will need to consider and address as vaccine guidance continues to evolve. Innovation: This study contributes to innovation in health communications by identifying emerging challenges and barriers in the ongoing effort to promote COVID-19 vaccination.

Perceptions of adult Arkansans regarding trusted sources of information about the COVID-19 pandemic.

BACKGROUND: The United States leads the world in confirmed COVID-19 cases; Arkansas ranks fifth in average daily cases per 100,000. Historically, Americans relied on health communications from governmental sources and the news media. However, there has been a documented decline of trust in these sources. The present study seeks to understand trusted sources of information about COVID-19 to improve health messaging because research shows the level of trust is associated with adherence to recommendations. METHODS: Data were collected using an online survey from participants (N = 1221) who were 18 years of age or older and residing, employed, or accessing health care in Arkansas. A qualitative descriptive design was used to summarize participants' experiences and perceptions related to trusted sources of COVID-19 information. RESULTS: Two primary themes related to participants' perceptions of sources of information about COVID-19 are reported: 1) trusted sources of information and 2) distrust or lack of trust in sources of information. Several subthemes emerged within each primary theme. Results showed high trust in the academic medical center, federal and state public health agencies, and local health care providers. The study also documents diverging voices of distrust and uncertainty in making sense of contradictory information. Participants reported the main reason for their lack of trust was the rapidly changing information and the lack of consistency in information provided across sources. CONCLUSIONS: This finding provides insight into the importance of coordination between national, state, and local communications to bolster trust. Personal recommendations and testimonies from trusted health care providers and professionals could inform public health messaging interventions to increase vaccine uptake.

Long Covid: Online patient narratives, public health communication and vaccine hesitancy.

INTRODUCTION: This study combines quantitative and qualitative analyses of social media data collected through three key stages of the pandemic, to highlight the following: 'First wave' (March to May, 2020): negative consequences arising from a disconnect between official health communications, and unofficial Long Covid sufferers' narratives online.'Second wave' (October 2020 to January 2021): closing the 'gap' between official health communications and unofficial patient narratives, leading to a better integration between patient voice, research and services.'Vaccination phase' (January 2021, early stages of the vaccination programme in the UK): continuing and new emerging concerns. METHODS: We adopted a mixed methods approach involving quantitative and qualitative analyses of 1.38 million posts mentioning long-term symptoms of Covid-19, gathered across social media and news platforms between 1 January 2020 and 1 January 2021, on Twitter, Facebook, Blogs, and Forums. Our inductive thematic analysis was informed by our discourse analysis of words, and sentiment analysis of hashtags and emojis. RESULTS: Results indicate that the negative impacts arise mostly from conflicting definitions of Covid-19 and fears around the Covid-19 vaccine for Long Covid sufferers. Key areas of concern are: time/duration; symptoms/testing; emotional impact; lack of support and resources. CONCLUSIONS: Whilst Covid-19 is a global issue, specific sociocultural, political and economic contexts mean patients experience Long Covid at a localised level, needing appropriate localised responses. This can only happen if we build a knowledge base that begins with the patient, ultimately informing treatment and rehabilitation strategies for Long Covid.

Shared Determinants for Human Papillomavirus and COVID-19 Vaccination Intention: An Opportunity for Resource Consolidation.

PURPOSE: This study aimed at targeting shared factors that influence the prevention of multiple diseases, which can help address various health problems simultaneously. We identified correlates of human papillomavirus (HPV) vaccination that overlap with COVID-19 vaccination. DESIGN: Cross-sectional survey data. SETTING: Online Qualtrics recruitment panel. SUBJECT: Religious parents of 342 adolescents who were unvaccinated for HPV (response rate was 68.1%). MEASURES: Outcome variables were COVID-19 vaccination intention for (1) self, (2) child, and (3) HPV vaccination intention for child. Independent variables were psychological factors. Covariates were sociodemographic and socioeconomic factors. ANALYSIS: We conducted multivariate linear regressions on each outcome variable after controlling for covariates. RESULT: Some psychological correlates of HPV overlapped as protective factors for all three outcomes. Higher perceived vulnerability of child to HPV was associated with higher vaccination intention against COVID-19 for self (ß = .37, 95% confidence interval [CI] = .25-.48), child (ß = .32, .21-.44), and HPV for child (ß = .38, .27-.49). Higher perceived response efficacy of HPV vaccine was associated with greater vaccination intention against COVID-19 for self (ß = .46, .33-.59), child (ß = .41, .28-.53), and HPV for child (ß = .75, .64-.85). CONCLUSION: Given the overlap in HPV and COVID-19 vaccination correlates, interventions should target shared factors that address both diseases to maximize public health efforts. A major limitation of this study is the inability to measure the actual vaccination behavior.