Implicit IAT Measures and Neurophysiological fNIRS Markers in Response to High-Engagement Advertising.

Self-report measures partially explain consumers' purchasing choices, which are inextricably linked to cognitive, affective processes and implicit drives. These aspects, which occur outside of awareness and tacitly affect the way consumers make decisions, could be explored by exploiting neuroscientific technology. The study investigates implicit behavioural and neurovascular responses to emotionally arousing and high-engagement advertisements (COVID-19 content). High-engagement advertisements and control stimuli were shown in two experimental sessions that were counterbalanced across participants. During each session, hemodynamic variations were recorded with functional Near-Infrared Spectroscopy (fNIRS) of the prefrontal cortex (PFC), a neurophysiological marker for emotional processing. The implicit association task (IAT) was administered to investigate the implicit attitude. An increase in the concentration of oxygenated haemoglobin (O2Hb) was found for the high-engagement advertising when this category of stimuli was seen first. Specular results were found for deoxygenated haemoglobin (HHb) data. The IAT reported higher values for highly engaging stimuli. Increased activity within the PFC suggests that highly engaging content may be effective in generating emotional arousal and increasing attention when presented before other stimuli, which is consistent with the higher IAT scores, indicating more favourable implicit attitudes. This evidence suggests that the effectiveness of highly engaging advertising-related messages may be constrained by the order of advertisement administration.

Gambling advertising on Twitter before, during and after the initial Australian COVID-19 lockdown.

Background and aims: COVID-19 resulted in the shutdown of almost all sporting competitions and most venue-based gambling opportunities. This study examines how wagering operators in Australia responded, by examining their advertising. Methods: The study compared Twitter activity during lockdown (March-May 2020) to the previous year for four major wagering operators. Results: Wagering operators continued to advertise in earnest, changing their marketing mix to include more race betting content, as races continued to operate. Most also promoted the only sports available, such as table tennis or esports. When sports resumed, sports betting advertising quickly returned to normal, or exceeded previous levels. Despite more content being available in the case of two operators, engagement from the public during lockdown was similar to or lower than previously. Discussion and conclusion: These results indicate that gambling operators can adjust quickly to major changes. These shifts appear to have been successful, with the increase in race betting during this period almost completely offsetting the decreases in sports betting. This is likely due in part to changes in advertising, which have been associated with increased betting activity, particularly amongst vulnerable people. Responsible gambling messages were virtually non-existent on Twitter, which contrasts with mandatory requirements in other media. The study highlights that regulatory changes to advertising, e.g., banning some content, are likely to be met with substitution of content, rather than reduction, unless advertising volume is also capped. The study also highlights the adaptive capacity of the gambling industry in the face of major disruption to supply.

Recalled Exposure to COVID-19 Public Education Campaign Advertisements Predicts COVID-19 Vaccine Confidence.

This study examined the relationship between recalled exposure to the We Can Do This COVID-19 Public Education Campaign (the Campaign) and COVID-19 vaccine confidence (the likelihood of vaccination or vaccine uptake) in the general population, including vaccine-hesitant adults (the "Movable Middle"). Analyses used three waves of a triannual, nationally representative panel survey of adults in the U.S. fielded from January to November 2021 (n = 3,446). Proportional odds regression results demonstrated a positive, statistically significant relationship between past 4-month Campaign recall and vaccine confidence, controlling for lagged reports of Campaign recall and vaccine confidence; concurrent and lagged fictional campaign recall; survey wave; and sociodemographics. Results indicated that as one moves from no Campaign recall to infrequent recall, there is a 29% increase in the odds of being in a higher vaccine confidence category. Findings offer evidence of the impact of a COVID-19 public education campaign on increasing vaccine confidence.

Promoting the personal importation of therapeutic goods: recent legislative amendments to advertising regulations may impact consumer access and understanding.

Objective The personal importation scheme is a legislative mechanism that allows health consumers to import unapproved medicines under certain conditions. This article analyses the legal and policy basis for the scheme and considers how reforms to advertising laws for therapeutic goods may restrict communications about it. The article represents the first published analysis of the personal importation scheme's interaction with the communications of health professionals and buyer's clubs. It considers how these communications may be affected by legal amendments, particularly where unapproved medicines may be accessed through the scheme. Methods An examination of Australian therapeutic goods law concerning the personal importation scheme was conducted, including both the historical law and recent regulatory reforms. Illustrative tables were prepared to identify scheme-related advertising that may contravene therapeutic goods law. Risk estimates were allocated to several new legal rules to indicate whether health professionals or buyer's clubs would contravene these laws when promoting the scheme to health consumers for unapproved medicines. Results Representations made directly to the public by health practitioners or on buyer's clubs websites about accessing unapproved therapeutic goods through the personal importation scheme are likely to contravene one or more advertising laws. Conclusions The Therapeutic Goods Administration has very strong powers to initiate compliance or enforcement action for advertising breaches in Australia for many promotional practices. Arguably, in the age of the internet and in the context of emerging expensive medicines, these powers should not be used to restrict health practitioners or buyer's clubs from sharing information about the lawful personal importation scheme to health consumers in need. Nevertheless, the study finds that health practitioners who promote or refer to the availability of unapproved medicines through the personal importation scheme outside of a consultation are likely to contravene the law and may be subject to disciplinary or enforcement action.

Effects of COVID-19 outbreak in pricing and collaboration of a health-social dual-channel supply chain.

The coronavirus pandemic has affected most aspects of product supply and consumer behaviors and led to transformations in the supply chain. The COVID-19 pandemic and the requirements to reduce its prevalence have led many people to shop online and encouraged many manufacturers to sell their products online. In this study, a manufacturer, who intends to possess an online sales channel, and a retailer, who has an in-person sales channel, are considered. Then, pricing strategies and collaboration mechanisms between them in the health-social dual-channel supply chain are investigated. This study is developed in three models, including centralized, decentralized, and collaborated under Stackelberg game, whereas the optimal price of products in each channel, level of implementation of health and safety protocols in retailers, advertising level, and status of online shopping performance are obtained for improving customer trust. Moreover, the demand is represented as a function of selling prices of products in online and in-person shops, compliance level of health protocols, level of online shopping performance, and advertising in health during the COVID-19 pandemic. Although the centralized model provides more profit for the manufacturer, the collaborated model provides the highest profit for the retailer. Thus, since the supply chain profit of centralized and collaborated models is close, the collaboration model is the best option for members in this situation. Sensitivity analysis is finally performed to evaluate the impact of key parameters, and then according to obtained results, some management insights are suggested for the dual-channel supply chain during the COVID-19 pandemic.

Health Communication in the Time of COVID-19 Pandemic: A Qualitative Analysis of Italian Advertisements.

In the climate of great uncertainty characterizing the COVID-19 pandemic, health communication played a significant role: several communicative strategies and channels were used to inform, educate and alert. Entropy-related risks were soon translated into the "infodemic", a wide-spread phenomenon with psychosocial and cultural roots. Therefore, new challenges for public institutions occurred: public health communication, especially expressed through advertising and audiovisual spots, was engaged to offer key support in combatting the disease, mitigating its effects and supporting health and psychological wellbeing. This work aims to investigate how the Italian public institutions addressed those challenges by employing institutional spots. We tried to answer two main research questions: (a) in line with the literature concerning persuasive communication, what were the main variables that social advertising concerning health attitudes and behaviors relied on; and (b) how the different variables were combined to propose specific communicative pathways following both the different waves/phases of the COVID-19 pandemic and the elaboration likelihood model. To answer these questions, 34 Italian spots were analyzed by means of qualitative multimodal analysis (including scopes, major narratives themes, central and peripheral cues). The results enabled us to individuate different communicative pathways, oriented by inclusivity, functionality and contamination, in line with different rounds as well as with the holistic configurations of cultural narratives, central and peripheral cues.

A Scoping Review of Observational Studies on Food and Beverage Advertising on Social Media: A Public Health Perspective.

Popular social media platforms have been actively used by ultra-processed food companies to promote their products. Being exposed to this type of advertising increases the consumption of unhealthy foods and the risk of developing obesity and other non-communicable diseases (NCDs). Thus, monitoring commercial content on social media is a core public health practice. We aimed to characterize the methods used for monitoring food advertising on social media and summarize the investigated advertising strategies via a scoping review of observational studies. This study is reported according to the MOOSE Statement, and its protocol was registered with the PROSPERO International Prospective Register of Systematic Reviews (registration nº. CRD42020187740). Out of the 6093 citations retrieved, 26 met our eligibility criteria. The studies were published from 2014 to 2021, mostly after 2018. They focused on Australia, Facebook, strategies aimed at children and adolescents, and advertising practices of ultra-processed food companies. We grouped strategies in eight classes: post features (n = 18); connectivity and engagement (n = 18); economic advantages, gifts, or competitions (n = 14); claims (n = 14); promotional characters (n = 12); brand in evidence (n = 8); corporate social responsibility or philanthropy (n = 7); and COVID-19 (n = 3). We found similarities in the investigation of strategies regardless of the type of social media. Our findings can contribute to the designing of tools for monitoring studies and regulatory mechanisms to restrict the exposure of food advertising.

Digital public health interventions at scale: The impact of social media advertising on beliefs and outcomes related to COVID vaccines.

Public health organizations increasingly use social media advertising campaigns in pursuit of public health goals. In this paper, we evaluate the impact of about $40 million of social media advertisements that were run and experimentally tested on Facebook and Instagram, aimed at increasing COVID-19 vaccination rates in the first year of the vaccine roll-out. The 819 randomized experiments in our sample were run by 174 different public health organizations and collectively reached 2.1 billion individuals in 15 languages. We find that these campaigns are, on average, effective at influencing self-reported beliefs-shifting opinions close to 1% at baseline with a cost per influenced person of about $3.41. Combining this result with an estimate of the relationship between survey outcomes and vaccination rates derived from observational data yields an estimated cost per additional vaccination of about $5.68. There is further evidence that campaigns are especially effective at influencing users' knowledge of how to get vaccines. Our results represent, to the best of our knowledge, the largest set of online public health interventions analyzed to date.

A 2 million-person, campaign-wide field experiment shows how digital advertising affects voter turnout.

We present the results of a large, US$8.9 million campaign-wide field experiment, conducted among 2 million moderate- and low-information persuadable voters in five battleground states during the 2020 US presidential election. Treatment group participants were exposed to an 8-month-long advertising programme delivered via social media, designed to persuade people to vote against Donald Trump and for Joe Biden. We found no evidence that the programme increased or decreased turnout on average. We found evidence of differential turnout effects by modelled level of Trump support: the campaign increased voting among Biden leaners by 0.4 percentage points (s.e. = 0.2 pp) and decreased voting among Trump leaners by 0.3 percentage points (s.e. = 0.3 pp) for a difference in conditional average treatment effects of 0.7 points (t1,035,571 = -2.09; P = 0.036; [Formula: see text] points; 95% confidence interval = -0.014 to 0). An important but exploratory finding is that the strongest differential effects appear in early voting data, which may inform future work on early campaigning in a post-COVID electoral environment. Our results indicate that differential mobilization effects of even large digital advertising campaigns in presidential elections are likely to be modest.

A practical guide to implementing a successful social media recruitment strategy: lessons from the Eczema Monitoring Online trial.

BACKGROUND: Participant recruitment into clinical trials remains challenging. The global increase in the number of social media users has accelerated the use of social media as a modality of recruitment, particularly during the COVID-19 pandemic when traditional recruitment methods were reduced. However, there is limited evidence on the performance of social media recruitment strategies into eczema clinical trials. METHODS: From September 2021 to January 2022, we recruited participants with eczema into an online randomised controlled trial using free advertising on Twitter, Facebook, Instagram and Reddit (unpaid methods), followed by paid Facebook advertisements (paid method). Unpaid methods were used periodically for 63 days, whilst the paid method for 16 days. Interested individuals who clicked on the advertisement link were directed to the study website, where they could sign up to participate. Consenting, randomisation and data collection occurred exclusively online, using a database management web platform. Evaluation of the social media recruitment methods was performed, including the number of expression of interests, enrolment yield, cost, baseline characteristics and retention. RESULTS: Our multi-platform based social media recruitment strategy resulted in 400 expressions of interests, leading to 296 participants. Unpaid methods accounted for 136 (45.9%) of participants, incurring no financial cost. Paid Facebook adverts reached 154,370 individuals, resulting in 123 (41.6%) trial participants for a total cost of £259.93 (£2.11 per participant) and other recruitment methods resulted in 37 (12.5%) enrolments. Paid advertisements predominantly attracted younger participants below the age of 20, whereas unpaid methods mainly drew in participants between 20-29 years of age. The social media platforms recruited an ethnically diverse participant population. Completion rate of follow-up was slightly higher for the paid method (n = 103, 83.7%) compared with the unpaid methods (n = 111, 81.6%). CONCLUSIONS: Unpaid social media posts recruited the most participants; however, it was time consuming for the researcher. Paid Facebook adverts rapidly recruited a large number of participants for a low cost and provided flexibility to target specific audiences. Our findings indicate that social media is an efficient tool that can potentially support recruitment to clinical trials. TRIAL REGISTRATION: ISRCTN45167024. Registered on 29 June 2021.

Strategies for Recruiting Migrants to Participate in a Sexual Health Survey: Methods, Results, and Lessons.

In this article, we describe the approaches taken to recruit adult migrants living in Australia for a sexual health and blood-borne virus survey (paper and online) and present data detailing the outcomes of these approaches. The purpose was to offer guidance to redress the under-representation of migrants in public health research. Methods of recruitment included directly contacting people in individual/organizational networks, social media posts/advertising, promotion on websites, and face-to-face recruitment at public events/venues. Search query strings were used to provide information about an online referral source, and project officers kept records of activities and outcomes. Descriptive statistical analyses were used to determine respondent demographic characteristics, proportions recruited to complete the paper and online surveys, and sources of referral. Logistic regression analyses were run to predict online participation according to demographic characteristics. The total sample comprised 1454 African and Asian migrants, with 59% identifying as female. Most respondents (72%) were recruited to complete the paper version of the survey. Face-to-face invitations resulted in the highest number of completions. Facebook advertising did not recruit large numbers of respondents. Same-sex attraction and age (40-49 years) were statistically significant predictors of online completion. We encourage more researchers to build the evidence base on ways to produce research that reflects the needs and perspectives of minority populations who often bear the greatest burden of disease.

Experimental evidence on improving COVID-19 vaccine outreach among migrant communities on social media.

Studies from several countries suggest that COVID-19 vaccination rates are lower among migrants compared to the general population. Urgent calls have been made to improve vaccine outreach to migrants, however, there is limited evidence on effective approaches, especially using social media. We assessed a targeted, low-cost, Facebook campaign disseminating COVID-19 vaccine information among Arabic, Turkish and Russian speakers in Germany (N = 888,994). As part of the campaign, we conducted two randomized, online experiments to assess the impact of the advertisement (1) language and (2) depicted messenger (government authority, religious leader, doctor or family). Key outcomes included reach, click-through rates, conversion rates and cost-effectiveness. Within 29 days, the campaign reached 890 thousand Facebook users. On average, 2.3 individuals accessed the advertised COVID-19 vaccination appointment tool for every euro spent on the campaign. Migrants were 2.4 (Arabic), 1.8 (Russian) and 1.2 (Turkish) times more likely to click on advertisements translated to their native language compared to German-language advertisements. Furthermore, findings showed that government representatives can be more successful in engaging migrants online compared to other messengers, despite common claims of lower trust in government institutions among migrants. This study highlights the potential of tailored, and translated, vaccination campaigns on social media for reaching migrants who may be left out by traditional media campaigns.

Sugary Beverage Advertising to Black and Hispanic Youth in the United States: A Call for Action.

The obesity epidemic remains a major public health issue worldwide, and it is pronounced in the United States. As rates of obesity continue to increase, children now experience obesity at younger ages, which predisposes them to early-onset obesity-related diseases. Of note, Black and Hispanic children experience obesity at higher rates compared with their White counterparts. Although there are many factors that contribute to higher rates of obesity, the increased consumption of sugar-sweetened beverages is one such contributor. Despite the dire state of obesity in these populations, sugar-sweetened beverage companies continue to increase their advertisements to Black and Hispanic children, which can negatively influence the childhood obesity epidemic. This article discusses the effect that sugar-sweetened beverages and their advertisements have on children in underrepresented communities. [Pediatr Ann. 2022;51(9):e370-e372.].

Excessive Gaming and Online Energy-Drink Marketing Exposure Associated with Energy-Drink Consumption among Adolescents.

In this study, we examined excessive online gaming by adolescents and the resultant effects of their exposure to the online marketing of energy drinks and alcohol, and whether marketing literacy could serve as a mitigating factor. This cross-sectional study was conducted in 2020. Data were obtained from a sample of 2613 seventh-grade students from 30 middle schools in Taiwan. A self-administered questionnaire was conducted. The results showed that nearly 18% of the adolescent respondents had used energy drinks, while 75% reported seeing energy-drink advertisements on the internet in the past year. Multiple regression results indicated that factors such as being male, reporting excessive gaming, being exposed to higher levels of online energy-drink marketing, and reporting alcohol use were positively associated with energy-drink consumption. A higher level of online energy-drink marketing-affective literacy, however, was negatively associated with energy-drink consumption. In conclusion, factors that predicted energy-drink consumption among adolescents included excessive gaming and exposure to online energy-drink marketing, but marketing-affective literacy tended to lessen the impact of such advertising.

Utilizing Social Media Advertisements and Participant Social Networks to Recruit African American Breast Cancer Survivors: Design and Rationale.

Purpose: Our objective is to pilot an advertisement-driven sampling procedure among African American (AA) breast cancer survivors living in Maryland. These pilot study methods will inform a future population-based study of AA breast cancer survivors at high risk of poor outcomes due to biological differences and social inequities. Methods: This cross-sectional study utilizes an innovative, social media-based advertisement campaign with an associated social media study page to recruit 100 AA breast cancer survivors. Participants are biologically female, aged 18 and older, identify as AA/Black, have a diagnosis of breast cancer, and reside in Maryland. A preset "Audience" was created via Meta (formerly Facebook) to automatically target potential interest in the online study via geolocation and public social media interests (estimated range = 101,000 women). Eligible participants complete an online survey including demographic and clinical characteristics, cancer screening, healthcare access, and utilization, COVID-19 impact, quality of doctor-patient communication, and preferences for future study participation. Results: Recruitment began on 5 January 2022 and remains ongoing. As of 7 June 2002: 124 completed the screener, 110/124 (88.7%) consented passively, 24/110 (21.8%) started but did not complete survey, 86/110 (78.1%) completed the survey. Conclusions: Results from this study will inform a statewide multilevel prospective population-based study to improve health behaviors, disease management, and self-efficacy of chronic disease management among AA breast cancer survivors.

Exploring the potential impact of the proposed UK TV and online food advertising regulations: a concept mapping study.

OBJECTIVES: In July 2020 the UK Government announced an intention to restrict advertisements for products high in fat, salt or sugar on live broadcast, catch-up and on-demand television before 21:00 hours; and paid for online advertising. As no other jurisdiction has implemented similar regulations, there is no empirical evidence about how they might perturb the food system. To guide the regulations' implementation and evaluation, we aimed to develop a concept map to hypothesise their potential consequences for the commercial food system, health and society. METHODS: We used adapted group concept mapping in four virtual workshops with food marketing and regulation experts across academia, civil society, government organisations, and industry (n=14), supported by Miro software. We merged concepts derived from the four workshops to develop a master map and then invited feedback from participants via email to generate a final concept map. RESULTS: The concept map shows how the reactions of stakeholders to the regulations may reinforce or undermine the impact on the commercial food system, health and society. The map shows adaptations made by stakeholders that could reinforce, or undermine, positive impacts on public health. It also illustrates potential weaknesses in the design and implementation of the regulations that could result in little substantial difference to public health. CONCLUSIONS: Prior to the regulations' initial implementation or subsequent iterations, they could be altered to maximise the potential for reinforcing adaptations, minimise the potential for undermining adaptations and ensure they cover a wide range of advertising opportunities and foods. The concept map will also inform the design of an evaluation of the regulations and could be used to inform the design and evaluation of similar regulations elsewhere.

Is Exposure to Social Media Advertising and Promotion Associated with E-cigarette Use? Evidence from Indonesia.

BACKGROUND: E-cigarette use is a growing public health concern globally, including in Indonesia. OBJECTIVE: Our study aimed to assess whether exposure to advertising and promotion in social media is associated with e-cigarette use in Indonesia, an upper-middle-income country. METHODS: We conducted mixed-method research including quantitative and qualitative methods. For the quantitative methods, we did an online survey in the five largest cities in the country with 1,239 participants during September-October 2020. For the qualitative method, we conducted an in-person focused group discussion during November 2020 (while complying to the COVID-19 protocols). RESULTS: We found high rates of e-cigarette ever use (29%) and current use (13%) among study participants. There was high exposure to e-cigarette advertising and promotion in social media, with a majority of participants (84%) reported ever seeing e-cigarette adverts or promotions on Facebook, Instagram, YouTube, and others. Both high rates of e-cigarette use and exposure to social media advertising are associated. Participants reported ever seeing adverts and promotions were 2.91 times and 2.82 times more likely ever to use and currently use e-cigarettes, respectively, after controlling for socioeconomic factors, region, and cigarette smoking status. CONCLUSION: Exposure to social media advertising and promotion is associated with e-cigarette use in Indonesia.

Pilot study of peer modeling with psychological inoculation to promote coronavirus vaccination.

Promoting coronavirus vaccination is deterred by misinformation, ranging from elaborate conspiracy theories about sinister purposes to exaggeration of side effects, largely promulgated by social media. In this pilot study, we tested the effects of different messages on actions leading to vaccination. Two theory-based advertisements were produced for Facebook, which provided video testimonials from peer role models recommending vaccination and its benefits while providing psychological inoculation through the models' acknowledging misinformation, rejecting it and receiving the vaccine. These ads were paid to appear on Facebook users' feeds in rural counties in South Texas, along with a generic vaccine promotion ad from the CDC without peer models or psychological inoculation. Ad viewers could click a link to 'find a vaccine near you'; these responses served as the outcome variable for assessing experimental effects. Ads featuring peer modeling with psychological inoculation yielded a significantly higher rate of positive responses than CDC ads (30.5 versus14.9/1000 people reached in English and 49.7 versus 31.5/1000 in Spanish; P < 0.001 for both English and Spanish rate comparisons). This provides useful pilot data supporting the hypothesis that theory-based communication, i.e. peer modeling with psychological inoculation, may be more effective than more traditional forms of advertising for promoting coronavirus vaccination.