Effectiveness of a 5-year health empowerment programme on promoting cardiovascular health for adults from low-income families in Hong Kong.

OBJECTIVE: This study aimed to evaluate the effectiveness of a health empowerment programme (HEP) to enhance cardiovascular health for adults from low-income families. METHODS: A prospective cohort study (N = 219, Intervention group: n = 103, comparison group: n = 116) was conducted with participants recruited from January 2013 to November 2015 and followed up until January 2022. Throughout the study duration, intervention group were invited to participate in the HEP. The cardiovascular health status of both groups at baseline and follow-up were assessed using the adapted Ideal Cardiovascular Health Index (ICHI) defined by the American Heart Association. After inverse propensity score weighting, multiple linear regression and Poisson regression were employed to examine the effects of the HEP. RESULTS: The HEP was associated with a greater increase in ICHI total score (B = 0.33, p < 0.001), and the increase of proportion of people achieving a normal blood pressure (Incidence rate ratio: 3.39, p < 0.05). CONCLUSION: HEP can be an effective and sustainable strategy to reduce social disparities in cardiovascular health of adults from low-income families, as indicated by improvement in the ICHI total score and blood pressure status. PRACTICAL IMPLICATIONS: The sustainable HEP in the community setting has potential for generalizability and scalability to other financially challenged families.

The Impact of a Health Empowerment Program on Self-Care Enablement and Mental Health among Low-Income Families: Evidence from a 5 Year Cohort Study in Hong Kong.

Health empowerment can be an effective way to reduce health inequities. This prospective cohort study evaluated the 5 year impact of a health empowerment program (HEP) on health outcomes among adults from low-income families. The Patient Enablement Instrument version 2 (PEI-2), Depression, Anxiety and Stress Scale 21 (DASS-21), and 12 item Short-Form Health Survey version 2 (SF-12v2) were administered at baseline and follow-up for both intervention and comparison groups. A total of 289 participants (n = 162 for intervention group, n = 127 for comparison group) were included in the analysis. Most of the participants were female (72.32%), and aged from 26 to 66 years old (M = 41.63, SD = 6.91). Linear regressions weighted by inverse probability weighting using the propensity score showed that, after follow-up of 5 years, the intervention group demonstrated significantly greater increases in all items and total scores for the PEI-2 (all B > 0.59, p < 0.001), greater decreases in the DASS depression score (B = -1.98 p = 0.001), and greater increases in the Mental Component Summary score of the SF-12v2 (B = 2.99, p = 0.027) than the comparison group. The HEP may be an effective intervention enabling adults from low-income families to manage their health-related issues and improve their mental health, as evidenced by our study.

How Misinformation and Rebuttals in Online Comments Affect People's Intention to Receive COVID-19 Vaccines: The Roles of Psychological Reactance and Misperceptions.

This study investigated how exposure to negative and misleading online comments about the COVID-19 vaccination persuasive messages and the ensuing corrective rebuttals of these comments affected people's attitudes and intentions regarding vaccination. An online experiment was performed with 344 adults in the United States. The results showed that rebuttals by the Centers for Disease Control and Prevention, rather than those by social media users, indirectly increased people's willingness to receive the vaccine by reducing their psychological reactance to persuasive messages and their belief in the misinformation contained in the comments. Rebuttals by social media users became more effective in reducing reactance when people initially had stronger pro-vaccination attitudes.

Tracking the Influence of Misinformation on Elderly People's Perceptions and Intention to Accept COVID-19 Vaccines.

In this study, we surveyed low-income elderly people in Hong Kong and their family or friends to test a dual-path model with which we identified how misinformation in the media reached elderly people and how the elderly people's perception and acceptance of coronavirus disease 2019 (COVID-19) vaccines were influenced. The findings suggest that elderly people's own exposure to erroneous information regarding vaccines and COVID-19 in the media was positively associated with their misperceptions. In addition, their family or friends, who also received misinformation from the media, were found to relay the misleading or erroneous information to the elderly people, indicating a two-step flow of media influence. While previous studies have predominantly focused on the direct influence of misinformation in the media, our study suggests that social influence can also mediate the influence of misinformation in the media and negatively impacts elderly people's perceptions of COVID-19 vaccines.

Resistance to Masks During the COVID-19 Pandemic: How User Comments Drive Psychological Reactance to Health Campaigns.

Campaigns for mask-wearing have become widespread on digital platforms during the COVID-19 outbreak and have garnered varied responses in the form of comments. The present study conducts a 2 (comment position: pro-mask wearing vs. anti-mask wearing) × 2 (comment tone: civil vs. uncivil) between-subjects experiment to investigate whether and how the position and tone of comments accompanying a health campaign on social media affect people's psychological reactance toward the campaign. The results show that although anti-mask wearing comments following a social media mask-promoting post provoke individuals' perception about others' disapproval of the post, the perception did not trigger the individuals' psychological reactance to the post. Nevertheless, uncivil comments elicit anger, which arouses reactance and cause persuasion failure.

Understanding Health Information Behaviors of Migrant Domestic Workers during the COVID-19 Pandemic.

Migrant domestic workers (MDWs) in Hong Kong remain vulnerable during the COVID-19 pandemic. Obtaining accurate information is essential for MDWs as it helps them understand their predicament and protect themselves. Therefore, this study delves into the MDWs' health literacy by scrutinizing how they acquire, verify, and respond to pandemic-related information. Semi-structured interviews were conducted with 32 Indonesian MDWs, recruited through purposive and snowball sampling. The data were examined using a constant comparative approach in grounded theory. The findings reveal that the participants engaged in information seeking and scanning to obtain health crisis information, mainly through their friends, family members, and community organizations. The participants also verified the information using their judgment or by consulting other actors, such as local organizations and media outlets. The messages they obtained informed the means to protect themselves, which motivated them to adopt preventive measures. However, some also engaged in maladaptive coping, such as taking ineffective preventive actions. The participants also disseminated health crisis information throughout their social circle. This study concluded that MDWs performed four health information behaviors during the pandemic, namely information acquisition, authentication, sharing, and adoption of preventive measures. However, their information practices may change at different stages of the pandemic.

The Battle is On: Factors that Motivate People to Combat Anti-Vaccine Misinformation.

This study proposes a theory-driven model to concurrently examine the cognitive and emotional factors that motivate vaccine supporters to combat erroneous online anti-vaccination information. The model was tested using data from a web survey of 599 vaccination supporters in the United States. The vaccine supporters reported greater support for government regulation of misinformation when they perceived greater susceptibility among the general public to the influence of misinformation. Surprisingly, the perceived severity of the influence was inversely related to respondents' intention to correct misinformation. In addition, perceived susceptibility to the influence of anti-vaccine misinformation and perceived severity of its influence on others induced negative emotions that included anticipated guilt and anger. The negative emotions in turn motivate vaccine supporters to attitudinally support government's media restriction or behaviorally correct the online misinformation.

The Role of Influence of Presumed Influence and Anticipated Guilt in Evoking Social Correction of COVID-19 Misinformation.

Misinformation on social media pertaining to COVID-19 poses a great threat to public health. The active correction of misinformation by social media users and an understanding of the drivers of such behavior can help solve this ongoing issue. Drawing on the influence of presumed influence model and cognitive appraisal theory, an online experiment (N = 400) was conducted to examine how exposure to corrective messages with regard to COVID-19 misinformation induced individuals' threat appraisals of the influence of the misinformation on others and how these threat appraisals and the corresponding emotional responses motivated individuals to take corrective actions. The results suggested that people's perceptions of the severity of the influence of misinformation on others engendered anticipated guilt, which, in turn, strengthened their intentions to correct misinformation related to COVID-19. The study offers guidance on how to effectively craft a corrective message to encourage audiences to counter misinformation together.

COVID-19 vaccine hesitancy: The effects of combining direct and indirect online opinion cues on psychological reactance to health campaigns.

This study aims to examine whether and how user-generated comments and reaction emojis on COVID-19 vaccine-promoting Facebook posts induce psychological reactance to posts and vaccine hesitancy in audiences of the posts. An online experiment including 465 American adults showed that, compared with COVID-19 vaccine promotion posts accompanied by pro-vaccine comments, those accompanied by anti-vaccine comments provoked greater reactance in audiences through the mediating effects of bandwagon perception and the presumed influence of the posts on others. Greater reactance, in turn, increased audiences' COVID-19 vaccine hesitancy. Additionally, reaction emojis altered the comments' effects such that pro-vaccine comments triggered less reactance than anti-vaccine comments when the pro-vaccine comments were accompanied by agreement emojis (i.e., "like" and "love"); whereas there was no significant difference between pro-vaccine comments and anti-vaccine comments in reactance when the pro-vaccine comments were accompanied by rejection emojis (i.e., "angry" and "sad"). Furthermore, audiences' pre-existing attitudes did not affect the effects of opinion cues on their' reactance and vaccine hesitancy.