Multiple Messaging Strategies for Increasing HPV Vaccination Intentions among English- and Spanish-Speaking Parents in the United States and Mexico.

The reported study compared the impact of four influence strategies (agency assignment, enhanced active choice, deviance regulation marking, and temporal framing) on English- and Spanish-speaking parents' reported intention to vaccinate their children for HPV. An online experiment was conducted to examine the impact of the strategies. In a fractional factorial design, participating parents (N = 1663) were exposed to combinations of influence strategies in text messages presented as reminders they might receive from a healthcare provider about their child's eligibility for the vaccine series. The results indicated small but significant impacts of agency assignment, enhanced active choice, and deviance regulation marking on parents' reported vaccination intentions. The study adds to the research literature on HPV vaccination communication in two important respects. First, it demonstrated how incorporating evidence-based influence strategies into reminder messages can increase parents' vaccination intentions, an important precursor and predictor of actual vaccine uptake. Second, it sets an important precedent by examining the effects of influence strategies on vaccination intentions across different languages.

Geographic location or experience: Using PRISM to understand how people seek flood risk information.

Flooding is increasing worldwide, and with climate change, people need help understanding these changing conditions and that their flood risk may also change. This study extends the planned risk information seeking model (PRISM) into the flood risk domain and examines the antecedents that explain flood risk information seeking behavior. Using a survey reflective of the population in the state of Texas (N = 1079), this study includes an operationalization of risk perception specific to the complexity of floods and explores two key moderators in the PRISM model. Findings suggest that using PRISM to elaborate flood risk information seeking behaviors explains 48% of the variance in information seeking intent and 37% of the variance in affective risk perception. Using multigroup modeling, the findings also reveal that simply living in an area at high risk for floods does not significantly impact any relationships in the model. However, having experience with flooding increases the strength of risk perception paths-in particular, perceived probability of flood risk-and better explains flood risk information seeking. Suggestions for how to use communication to influence risk perceptions and information seeking, as well as future directions for research, are also discussed.

Evidence-based recommendations for communicating the impacts of climate change on health.

Climate change poses a multifaceted, complex, and existential threat to human health and well-being, but efforts to communicate these threats to the public lag behind what we know how to do in communication research. Effective communication about climate change's health risks can improve a wide variety of individual and population health-related outcomes by: (1) helping people better make the connection between climate change and health risks and (2) empowering them to act on that newfound knowledge and understanding. The aim of this manuscript is to highlight communication methods that have received empirical support for improving knowledge uptake and/or driving higher-quality decision making and healthier behaviors and to recommend how to apply them at the intersection of climate change and health. This expert consensus about effective communication methods can be used by healthcare professionals, decision makers, governments, the general public, and other stakeholders including sectors outside of health. In particular, we argue for the use of 11 theory-based, evidence-supported communication strategies and practices. These methods range from leveraging social networks to making careful choices about the use of language, narratives, emotions, visual images, and statistics. Message testing with appropriate groups is also key. When implemented properly, these approaches are likely to improve the outcomes of climate change and health communication efforts.

Climate change poses a tremendous and complex threat to human health and well-being. Efforts to communicate these threats to the public may not be as effective as desired and using evidence-based strategies could improve a wide variety of health-related outcomes for individuals and society while potentially reducing climate-related health disparities. In particular, effective communication can help people understand the crucial connection between climate change and health risks and empower them to act on that newfound knowledge and understanding. We recommend 11 communication methods that have been well tested in other domains and can be applied to the intersection of climate and health by healthcare professionals, decisionmakers, governments, the general public, and other stakeholders including those in sectors outside of health. These methods range from leveraging social networks to making careful choices about the use of language, narratives, emotions, visual images, and statistics. Message testing with appropriate groups is also key. When implemented properly, these approaches are likely to improve knowledge uptake and drive better decision making and healthier behaviors.

Computational medicine, present and the future: obstetrics and gynecology perspective.

Medicine is, in its essence, decision making under uncertainty; the decisions are made about tests to be performed and treatments to be administered. Traditionally, the uncertainty in decision making was handled using expertise collected by individual providers and, more recently, systematic appraisal of research in the form of evidence-based medicine. The traditional approach has been used successfully in medicine for a very long time. However, it has substantial limitations because of the complexity of the system of the human body and healthcare. The complex systems are a network of highly coupled components intensely interacting with each other. These interactions give those systems redundancy and thus robustness to failure and, at the same time, equifinality, that is, many different causative pathways leading to the same outcome. The equifinality of the complex systems of the human body and healthcare system demand the individualization of medical care, medicine, and medical decision making. Computational models excel in modeling complex systems and, consequently, enabling individualization of medical decision making and medicine. Computational models are theory- or knowledge-based models, data-driven models, or models that combine both approaches. Data are essential, although to a different degree, for computational models to successfully represent complex systems. The individualized decision making, made possible by the computational modeling of complex systems, has the potential to revolutionize the entire spectrum of medicine from individual patient care to policymaking. This approach allows applying tests and treatments to individuals who receive a net benefit from them, for whom benefits outweigh the risk, rather than treating all individuals in a population because, on average, the population benefits. Thus, the computational modeling-enabled individualization of medical decision making has the potential to both improve health outcomes and decrease the costs of healthcare.

Global health crises are also information crises: A call to action.

In this opinion paper, we argue that global health crises are also information crises. Using as an example the coronavirus disease 2019 (COVID-19) epidemic, we (a) examine challenges associated with what we term "global information crises"; (b) recommend changes needed for the field of information science to play a leading role in such crises; and (c) propose actionable items for short- and long-term research, education, and practice in information science.

Jumping in and Out of the Dirty Water Learning from Stories while Doing Social Science.

The pursuit of knowledge surrounding health-related issues during disasters, emergencies, and crises, can be delicate and challenging. Social scientists use a host of research methods to design and execute studies with the goal of making intellectual contributions. During extended field work following Hurricane Harvey in the Greater Houston area, our team collected data - interviews, observations, and private social media - from citizens, emergency responders, and volunteer rescuers. Yet sometimes the data collected, analyzed, and reported in published findings is only part of the research story. The researchers' experiences, both in the field as well as their past, can serve as personal-sensemaking devices. Integrating these stories can help scientists build trust and collect meaningful data, well beyond what is anticipated. In this essay, I share such examples, related to dirty water: temporarily health-compromised individuals, and responders doing double duty. Below the surface, there are many more opportunities for health communication to make an impact in times of crisis.

Persuasive texts for prompting action: Agency assignment in HPV vaccination reminders.

Vaccination reminders must both inform and persuade, and text messages designed for this purpose must do so in 160 characters or less. We tested a strategy for improving the impact of HPV vaccination text message reminders through strategic wording. In an experiment conducted in community settings, 167 Spanish-speaking Latina mothers reviewed text message reminders that assigned the cause or "agency" for HPV transmission to their daughters or the virus, and assigned protection agency to the mothers or the vaccine. Reminder messages framing transmission as an action of the virus prompted mothers to perceive the threat as more severe than messages describing their daughters as the cause. Assigning transmission agency to the virus also held a persuasive advantage in boosting mothers' intentions to seek vaccination, particularly when the message cast mothers as agents of protection rather than the vaccine.

Making Electronic Health Records (EHRs) Work: Informal Talk and Workarounds in Healthcare Organizations.

A key provision of the American Recovery and Reinvestment Act of 2009 mandated that electronic health records (EHR) be adopted in US healthcare organizations by 2015. The purpose of this study is to examine the communicative processes involved as healthcare workers implement an EHR and make changes, known as workarounds. Guided by theories in social influence, and diffusion of innovations, we conducted a survey of healthcare professionals using an EHR system in an organization. Our structural equation modeling (SEM) and multiple regression results reveal coworker communication, in the form of informal social support and feedback, play an important role in whether people engage in workarounds. Understanding this relationship is important because our study also demonstrates that workarounds predict healthcare employees' overall satisfaction with the EHR system. Specifically, workarounds are associated with higher perceptions of the EHR's relative advantage, higher perceptions of EHR implementation success, and lower levels of resistance to EHR change. This study offers a health communication contribution to the growing research on EHR systems and demonstrates the persuasive effects that coworkers have on new technology use in healthcare organizations.

Sharing Health Information and Influencing Behavioral Intentions: The Role of Health Literacy, Information Overload, and the Internet in the Diffusion of Healthy Heart Information.

Low health literacy remains an extremely common and problematic issue, given that individuals with lower health literacy are more likely to experience health challenges and negative health outcomes. In this study, we use the first three stages of the innovation-decision process found in the theory of diffusion of innovations (Rogers, 2003). We incorporate health literacy into a model explaining how perceived health knowledge, information sharing, attitudes, and behavior are related. Results show that health information sharing explains 33% of the variance in behavioral intentions, indicating that the communicative practice of sharing information can positively impact health outcomes. Further, individuals with high health literacy tend to share less information about heart health than those with lower health literacy. Findings also reveal that perceived heart-health knowledge operates differently than health literacy to predict health outcomes.

Design simplicity influences patient portal use: the role of aesthetic evaluations for technology acceptance.

OBJECTIVE: This study focused on patient portal use and investigated whether aesthetic evaluations of patient portals function are antecedent variables to variables in the Technology Acceptance Model. METHODS: A cross-sectional survey of current patient portals users (N = 333) was conducted online. Participants completed the Visual Aesthetics of Website Inventory, along with items measuring perceived ease of use (PEU), perceived usefulness (PU), and behavioral intentions (BIs) to use the patient portal. RESULTS: The hypothesized model accounted for 29% of the variance in BIs to use the portal, 46% of the variance in the PU of the portal, and 29% of the variance in the portal's PEU. Additionally, one dimension of the aesthetic evaluations functions as a predictor in the model - simplicity evaluations had a significant positive effect on PEU. CONCLUSION: This study provides evidence that aesthetic evaluations - specifically regarding simplicity - function as a significant antecedent variable to patients' use of patient portals and should influence patient portal design strategies.

Boosting healthy heart employer-sponsored health dissemination efforts: identification and information-sharing intentions.

Health information dissemination options have expanded to include workplaces and employer-sponsored efforts. This study focuses on a core relational concept found in workplaces, organizational identification-the feeling of belongingness-and the impact of partnering with employers and health clinics in health information dissemination. We use social-identity theory and multiple identification to test our predictions from a sample of working adults representing more than 100 different employers. We found that when people strongly identify with their employer, they have increased health behavioral intentions and they intend to talk about the health information with coworkers. The significant models explain more than 50% and 30% of the variance in these two outcomes. The experimental results examining single and multiple organizational sources revealed no differences on any outcomes. These findings offer a contribution to health information dissemination research by articulating how identification with an employer functions to affect behavioral intentions.

Organizations disseminating health messages: the roles of organizational identification and HITs.

Research into the dissemination of health information now includes more focus on how various organizations (e.g., beauty shops, schools, workplaces, and churches) and health information technologies (HITs) reach and affect audiences. One relational feature of organizations is identification--the feeling of belongingness. Our study explores how it influences audiences, especially in combination with HITs such as e-mail, websites, and social media. We use social identity theory to predict how organizational identification and social media might function in health communication. Using a 3 × 2 experimental design, we find that people's identification with a message source mediates the effect of social media on outcomes. These findings improve our understanding of when organizations might be most helpful for disseminating health information.

Expanding the reach of health campaigns: community organizations as meta-channels for the dissemination of health information.

This study investigates whether, and to what extent, community organizations can serve as viable channels of health information. We use Putnam's (2000) findings on social capital to argue that organizations can serve two major functions in health campaigns: instrumental (e.g., providing material support) and affinity (social support). Through a secondary analysis of data from the Stanford Five-City Project, we find significant support for our predictions about who joins community organizations. Membership in community organizations explains greater variance in health outcomes than that explained by general media use, demographic indicators, and health-specific media use. Implications for health campaigns are discussed.