Using immersive virtual reality to improve the beliefs and intentions of influenza vaccine avoidant 18-to-49-year-olds: Considerations, effects, and lessons learned.

OBJECTIVE: Only one-third of adults 18-49 years old in the United States receive a recommended annual influenza vaccination. This study examined whether supplementing vaccine information statements (VIS) with an immersive virtual reality (VR), short video or electronic pamphlet story designed to convey the community immunity benefits of influenza vaccination would improve influenza vaccine avoidant participants' influenza-related perceptions as well as their influenza vaccination-related beliefs, confidence and intentions. METHOD: A one-way between-subjects experimental design compared the effects of adding a supplemental education experience prior to VIS exposure with flu vaccine avoidant 18-to-49-year-olds. The 171 participants recruited from the community were randomly assigned to one of three modality treatment conditions [VR, video, or e-pamphlet (i.e., story board presented via electronic tablet)] or a VIS-only control condition. RESULTS: Compared to the modalities, the VR intervention created a stronger perception of presence (i.e., feeling of "being there" in the story), which, in turn, increased participants' concern about transmitting influenza to others and raised vaccination intention. Increased concern about transmitting influenza to others was associated with positive effects on influenza vaccination-related beliefs, including confidence that one's flu vaccination would protect others. Neither the e-pamphlet nor the video intervention were able to elicit a sense of presence nor were they able to improve the impact of the VIS on the outcome measures. CONCLUSIONS: Immersive VR has much potential to increase understanding of key immunization concepts, such as community immunity, through creative executions that increase a sense of presence. Given the need to increase influenza vaccination uptake among 18-to-49-year-olds, and the projected growth in VR accessibility and use, additional applications and assessments related to vaccination communication and education are needed and warranted. By increasing the ability to convey key vaccine and immunization concepts, immersive VR could help address vaccination hesitancy and acceptance challenges.

Understanding and Increasing Influenza Vaccination Acceptance: Insights from a 2016 National Survey of U.S. Adults.

Background: The percentage of adults in the U.S. getting seasonal influenza vaccination has not changed significantly since 2013 and remains far below the federal government's 70% target. Objective: This study assessed and identified characteristics, experiences, and beliefs associated with influenza vaccination using a nationally representative survey of 1005 U.S. adults 19 years old and older. Methods: The sample was drawn from the National Opinion Research Center's AmeriSpeak Panel, a probability-based panel designed to be representative of the U.S. household population. Results: Overall, 42.3% received an influenza vaccination in the past 12 months, with rates highest for non-Hispanic Whites and Blacks and those 65 years old and older. Hispanic respondents and those under 64 years old were much less likely to get an influenza vaccination. They were also less aware of the recommendation, less informed about influenza and the benefits of vaccination, and least confident in the vaccine. Conclusions: Increasing influenza vaccination coverage in the U.S. requires a greater focus on 19-64 year-olds, particularly those 50 to 64, Hispanics and continued focus on those with diabetes and asthma. Efforts need to increase awareness of influenza vaccination recommendations, foster a sense of being well informed about influenza vaccination benefits and the risks associated with non-vaccination, and increase confidence that there are meaningful benefits from receiving an influenza vaccination.

What Is the Story with Narratives? How Using Narratives in Journalism Changes Health Behavior.

Health journalists frequently use narratives to bring news stories to life, with little understanding about how this influences the health behavior of readers. This study was designed to examine the effect of a New York Times health news article about a person who developed a life-threatening illness after using ibuprofen on readers' future use of ibuprofen. We recruited an Internet sample (N = 405) to participate in a longitudinal study examining ibuprofen use before, immediately following, and two weeks after reading the story. Ibuprofen use two-weeks after reading the heath news article was significantly lower than baseline use. Furthermore, intentions to use ibuprofen were also significantly reduced suggesting that the observed behavior change may persist beyond the two-week period studied. Health journalists should be cautious in their use of stories about health outcomes, particularly when those stories deviate from data about objective risks.

How does patient-provider communication influence adherence to asthma medications?

OBJECTIVE: To assess hypothesized pathways through which patient-provider communication impacts asthma medication adherence. METHODS: A national sample of 452 adults with asthma reported assessments of patient-provider communication, proximal outcomes (understanding of asthma self-management, patient-provider agreement, trust in the clinician, involvement in care, motivation), and adherence to asthma medications. Structural equation modeling was used to examine hypothesized pathways. RESULTS: Significantly positive direct pathways were found between patient-provider communication and all proximal outcomes. Only positive indirect pathways, operating through trust and motivation, were found between patient-provider communication and medication adherence. CONCLUSION: Patient-provider communication influences many desirable proximal outcomes, but only influences adherence through trust and motivation. PRACTICE IMPLICATIONS: To promote better adherence to asthma medication regimens and, ultimately positive asthma outcomes, healthcare providers can focus on implementing communication strategies that strengthen patients' trust and increase patient motivation to use asthma medications.

Defining obesity: second-level agenda setting attributes in black newspapers and general audience newspapers.

This content analysis study examines how obesity is depicted in general-audience and Black newspaper stories (N=391) through the lens of second-level agenda setting theory. The results reveal that both Black newspapers and general-audience newspapers generally ascribe individual causes for obesity. While both types of newspapers largely neglected to mention solutions for the problem, Black newspapers were more likely than general-audience newspapers to suggest both individual and societal solutions for treating obesity. For Black newspapers, these solutions more often included community interventions. In addition, Black newspapers more often used a negative tone in stories and more frequently mentioned ethnic and racial minorities as at-risk groups.

JOURNALISTIC USE OF EXEMPLARS TO HUMANIZE HEALTH NEWS.

Health journalists often use personal stories to put a "face" on a health issue. This research uses a sociology-of-news approach, based on data collected from 42 in-depth interviews and three surveys with health journalists and editors [national (N = 774), state (N = 55), and purposive (N = 180)], to provide a first look at how important journalists think exemplars are to their stories. Results show journalists select exemplars to inform, inspire, and/or sensationalize a health issue. Some of the strategies journalists use to locate exemplars pose ethical concerns. Further, journalists rank the use of exemplars lower in aiding audience understanding compared with the use of experts, data and statistics, and definitions of technical terms.

Are health journalists' practices tied to their perceptions of audience? An attribution and expectancy-value approach.

This study examines a national survey of U.S. health journalists (N = 774) to ascertain how journalists' perceptions of audience use of health news shapes their journalistic practices. We establish a framework through attribution theory and expectancy-value theory for how journalists choose to fulfill their roles as providers of health information. Using these theoretical lenses, we look at whether health journalists' audience orientation is associated with their use of accessibility-oriented or credibility-focused practices. Our findings show that, overall, journalists believe readers are individually responsible for their health outcomes and that journalists focus on providing accessibility-oriented information when they feel their audience's ability to understand information may be compromised. Journalists' beliefs about audience behavior are associated with their attitudes toward communication practices.

Readers Use Black Newspapers for Health/Cancer Information.

A national survey of readers of black newspapers shows that whether readers depend on black newspapers for cancer and health information depends on their black newspaper use, black self-identity and general media dependency.