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Xia S, Nan X. Motivating COVID-19 Vaccination through Persuasive Communication: A Systematic Review of Randomized Controlled Trials. HEALTH COMMUNICATION 2024; 39:1455-1478. [PMID: 37254940 DOI: 10.1080/10410236.2023.2218145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Vaccination is a vital defense against COVID-19 infections and outbreaks, yet vaccine hesitancy poses a significant threat to pandemic response and recovery. We conducted a systematic review of published randomized controlled trials (N = 47) assessing the persuasive effects of COVID-19 communication on COVID-19 vaccine acceptance. Individual vs. collective appeals and gain vs. loss frames are among the most frequently assessed message features, but they generally do not make a difference in persuasion. Normative messages that highlight higher (vs. lower) prevalence of vaccine acceptance are more persuasive. Message sources overall have limited impact on COVID-19 vaccine acceptance, but sources that have a shared identity with the message receivers tend to be persuasive. More engaging message channels such as interactive chatbots and videos are promising communication tools but are generally under-utilized and under-studied. Compared to no communication or irrelevant communication, COVID-19 vaccine messages generally have a small advantage in increasing COVID-19 vaccine acceptance. Messages that include 1) vaccine safety and/or efficacy information; 2) collective appeals combined with embarrassment appeals; and 3) political leaders' vaccine endorsement are among the most effective messaging strategies. There is no evidence of any backfire effects of COVID-19 vaccine messages. We discuss the implications of our findings for persuasive message design in pandemic vaccine communication.
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Affiliation(s)
- Shilin Xia
- Department of Communication, University of Maryland
| | - Xiaoli Nan
- Department of Communication, University of Maryland
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2
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Kirkpatrick CE, Hu S, Lee N, Hong Y, Lee S, Hinnant A. Overcoming Black Americans' Psychological and Cognitive Barriers to Clinical Trial Participation: Effects of News Framing and Exemplars. HEALTH COMMUNICATION 2023; 38:2663-2675. [PMID: 35924326 PMCID: PMC10809270 DOI: 10.1080/10410236.2022.2105619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
This study examines how news features (framing and the use of exemplars) can help overcome two common barriers (psychological and cognitive) impeding Black American participation in clinical trials. In an online experiment, Black participants (N = 390) viewed social media news posts varying in framing (focus on psychological vs. cognitive barriers) and use of an exemplar (present vs. absent and White vs. Black) and then responded to outcome measures including perceived message effectiveness, message attitudes, and intention to participate in clinical trials. The findings illustrate that including a racially matched (i.e. Black) exemplar improves attitudes toward clinical trial messages. Most notably, featuring a race-matched exemplar increases intention to participate in a trial when the messages discuss psychological barriers. These findings enhance our understanding of how messages can be better designed to increase Black American participation in clinical trials, thereby contributing to reducing health inequities and improving health outcomes.
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Affiliation(s)
- Ciera E. Kirkpatrick
- Advertising & Public Relations, College of Journalism & Mass Communications, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Sisi Hu
- Advertising, School of Journalism and Strategic Media, University of Arkansas, Fayetteville, Arkansas, USA
| | - Namyeon Lee
- Department of Mass Communication, University of North Carolina at Pembroke, Pembroke, North Carolina, USA
| | - Yoorim Hong
- Strategic Communication, School of Journalism, University of Missouri, Columbia, Missouri, USA
| | - Sungkyoung Lee
- Strategic Communication, School of Journalism, University of Missouri, Columbia, Missouri, USA
| | - Amanda Hinnant
- Journalism Studies, School of Journalism, University of Missouri, Columbia, Missouri, USA
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Lois A, Kohler JE, Monsell SE, Pullar KM, Victory J, Odom SR, Fischkoff K, Kaji AH, Evans HL, Sohn V, Kao LS, Dodwad SJ, Ehlers AP, Alam HB, Park PK, Krishnadasan A, Talan DA, Siparsky N, Price TP, Ayoung-Chee P, Chiang W, Salzberg M, Jones A, Kutcher ME, Liang MK, Thompson CM, Self WH, Bizzell B, Comstock BA, Lavallee DC, Flum DR, Fannon E, Kessler LG, Heagerty PJ, Lawrence SO, Pham TN, Davidson GH. A Video-Based Consent Tool: Development and Effect of Risk-Benefit Framing on Intention to Randomize. J Surg Res 2023; 283:357-367. [PMID: 36427446 DOI: 10.1016/j.jss.2022.10.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 08/14/2022] [Accepted: 10/16/2022] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Nearly 75% of clinical trials fail to enroll enough participants, and cohorts often fail to reflect the clinical and demographic diversity of at-risk populations. Effective recruitment strategies are critically important for successful clinical trials. Framing treatment risks are known to affect medical decision-making for both physicians and patients but has not been rigorously studied in surgical trials. We sought to examine the impact of a high-quality video-based consent tool and the effect of risk-benefit framing on patient willingness to participate in a surgical clinical trial. METHODS A standardized video consent was shown to all potential participants in the Comparison of Outcomes of antibiotic Drugs and Appendectomy (CODA) trial, a randomized controlled trial comparing antibiotics and surgery for acute appendicitis. We report (1) differences in recruitment between two versions of a video-based tool that differed in production quality and (2) the impact of risk-benefit framing on participant randomization rates. The reasons for declining randomization were also assessed. RESULTS Of 4697 eligible patients approached to participate in the CODA trial, 1535 (33% [95% confidence interval (CI): 31%-34%]) agreed to randomization; this did not change from video version 1 to version 2. There was no difference in participation between positively framed videos (32% [95% CI: 30%-34%]) versus negatively framed videos (33.0% [95% CI: 30.8-35.2]). The most common reason for declining participation was treatment preference (72% for surgery and 18% for antibiotics). CONCLUSIONS Neither the change from video 1 to video 2 nor the positive versus negative framing affected participant willingness to randomize. The stakeholder-informed video-based consenting tool used in CODA was an effective strategy for the recruitment of a heterogeneous patient population within the proposed study period.
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Harkness A, Rogers BG, Balise R, Mayo D, Weinstein ER, Safren SA, Pachankis JE. Who Aren't We Reaching? Young Sexual Minority Men's Non-participation in an HIV-Prevention and Mental Health Clinical Trial. AIDS Behav 2021; 25:2195-2209. [PMID: 33483898 PMCID: PMC8169533 DOI: 10.1007/s10461-020-03148-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 11/29/2022]
Abstract
Despite many successful clinical trials to test HIV-prevention interventions for sexual minority men (SMM), not all SMM are reached by these trials. Identifying factors associated with non-participation in these trials could help to ensure the benefits of research extend to all SMM. Prospective participants in New York City and Miami were screened to determine eligibility for a baseline assessment for a mental health/HIV-prevention trial (N = 633 eligible on screen). Logistic regression and classification and regression tree (CART) analysis identified predictors of non-participation in the baseline, among those who were screened as eligible and invited to participate. Individuals who reported unknown HIV status were more likely to be non-participators than those who reported being HIV-negative (OR = 2.39; 95% CI 1.41, 4.04). In New York City, Latinx SMM were more likely to be non-participators than non-Latinx white SMM (OR = 1.81; 95% CI, 1.09, 2.98). A CART model pruned two predictors of non-participation: knowledge of HIV status and age, such that SMM with unknown HIV status and SMM ages 18-19 were less likely to participate. Young SMM who did not know their HIV status, and thus are more likely to acquire and transmit HIV, were less likely to participate. Additionally, younger SMM (18-19 years) and Latinx SMM in New York City were less likely to participate. The findings suggest the importance of tailored recruitment to ensure HIV-prevention/mental health trials reach all SMM.
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Affiliation(s)
- Audrey Harkness
- Department of Public Health Sciences, University of Miami, Clinical Research Building, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA.
| | - Brooke G Rogers
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Raymond Balise
- Department of Public Health Sciences, University of Miami, Clinical Research Building, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA
| | - Daniel Mayo
- Department of Psychology, University of Miami, Miami, FL, USA
| | | | - Steven A Safren
- Department of Psychology, University of Miami, Miami, FL, USA
| | - John E Pachankis
- Department of Chronic Disease Epidemiology, Social and Behavioral Sciences Division, Yale School of Public Health, Yale University, New Haven, CT, USA
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Langford AT. Health Communication and Decision Making about Vaccine Clinical Trials during a Pandemic. JOURNAL OF HEALTH COMMUNICATION 2020; 25:780-789. [PMID: 33719877 PMCID: PMC8765457 DOI: 10.1080/10810730.2020.1864520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The COVID-19 pandemic has magnified the importance of clinical trials for finding a safe and effective vaccine to protect against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19. Although communication about vaccines and vaccine hesitancy were challenges long before COVID-19, the twin facts of a pandemic and an "infodemic" of health information, misinformation, and disinformation have raised new challenges for vaccine-related communication and decision-making. The goal of this commentary is to highlight strategies to improve communication and decision-making for adults considering participation in COVID-19 vaccine clinical trials. First, I present a general conceptual model for clinical trial participation that can be applied to various vaccine and other clinical trial contexts. Next, I introduce the ASK (Assume, Seek, Know) approach for enhancing clinical trial participation: (1) assume that all patients will want to know their options, (2) seek the counsel of stakeholders, and (3) know your numbers. The ideas presented in this commentary are intended to enhance vaccine-specific clinical trial communication, decision-making, and literacy, while dually offering strategies and resources that may help reduce vaccine hesitancy and increase vaccine uptake over time.
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Affiliation(s)
- Aisha T Langford
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
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Witbracht MG, Bernstein OM, Lin V, Salazar CR, Sajjadi SA, Hoang D, Cox CG, Gillen DL, Grill JD. Education and Message Framing Increase Willingness to Undergo Research Lumbar Puncture: A Randomized Controlled Trial. Front Med (Lausanne) 2020; 7:493. [PMID: 33043024 PMCID: PMC7530193 DOI: 10.3389/fmed.2020.00493] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/20/2020] [Indexed: 12/26/2022] Open
Abstract
Reluctance to undergo lumbar puncture (LP) is a barrier to neurological disease biomarker research. We assessed whether an educational intervention increased willingness to consider research LP and whether message framing modified intervention effectiveness. We randomly assigned 851 recruitment registry enrollees who had previously indicated they were unwilling to be contacted about studies requiring LP to gain or loss framed video educational interventions describing the procedure and the probability of experiencing adverse events. The gain framed intervention emphasized the proportion of individuals free of adverse events; the loss frame emphasized the proportion experiencing adverse events. The primary outcome for the study was the participant's post-intervention agreement to be contacted about studies requiring LP. Participants were mean (SD) age 60.1 years (15.7), 69% female (n = 591), and mostly college educated and white. Among the 699 participants who completed the study, 43% (95% CI: 0.39, 0.47; n = 301) changed their response to agree to be contacted about studies requiring LP. We estimated that participants randomized to the gain framed intervention had 67% higher odds of changing their response compared to those randomized to the loss frame (Odds Ratio = 1.67; 95% CI: 1.24, 2.26; p < 0.001). A classification and regression tree model identified participants' pre-intervention willingness as the strongest predictor of changing response. Education, in particular education that alerts participants to the probability of not experiencing adverse events, may be an effective tool to increase participation rates in research requiring LP.
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Affiliation(s)
- Megan G Witbracht
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
| | - Olivia M Bernstein
- Department of Statistics, University of California, Irvine, Irvine, CA, United States
| | - Vanessa Lin
- Graduate Medical Sciences, Boston University School of Medicine, Boston, MA, United States
| | - Christian R Salazar
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
| | - S Ahmad Sajjadi
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States.,Department of Neurology, University of California, Irvine, Irvine, CA, United States
| | - Dan Hoang
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
| | - Chelsea G Cox
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
| | - Daniel L Gillen
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States.,Department of Statistics, University of California, Irvine, Irvine, CA, United States
| | - Joshua D Grill
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States.,Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, United States.,Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States.,Institute for Clinical and Translational Science, University of California, Irvine, Irvine, CA, United States
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Thabethe S, Slack C, Lindegger G, Wilkinson A, Wassenaar D, Kerr P, Bekker LG, Mngadi K, Newman PA. "Why Don't You Go Into Suburbs? Why Are You Targeting Us?": Trust and Mistrust in HIV Vaccine Trials in South Africa. J Empir Res Hum Res Ethics 2019; 13:525-536. [PMID: 30417754 PMCID: PMC6238163 DOI: 10.1177/1556264618804740] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Trust is a key element of high-quality stakeholder relations, which are themselves essential for the success of HIV vaccine trials. Where trust is absent, community stakeholders might not volunteer to become involved in key trial activities, and potential participants might not volunteer for enrollment. We explored site staff and Community Advisory Board (CAB) members’ experiences of trust/mistrust among community members and potential participants. We analyzed 10 focus group discussions with site staff and CAB members at two active South African HIV vaccine trial sites. We report on key characteristics perceived to contribute to the trustworthiness of communicators, as well as factors associated with mistrust. Attributes associated with trustworthy communicators included shared racial identity, competence, and independence (not being “captured”). Key foci for mistrust included explanations about site selection, stored samples, vaccination, and Vaccine Induced Sero-Positivity (VISP). Our findings suggest that community members’ trust is not necessarily global, in which trials are trusted or not; rather, it appears fairly nuanced and is impacted by various perceived attributes of communicators and the information they provide. We make recommendations for clinical trial site stakeholders invested in building trust and for future research into trust at these sites.
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Affiliation(s)
| | - Catherine Slack
- 1 University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | | | | | | | - Philippa Kerr
- 1 University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | | | - Kathy Mngadi
- 3 Centre for the AIDS Programme of Research in South Africa, Durban, South Africa.,4 The Aurum Institute, Johannesburg, South Africa
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Browne JL, Rees CO, van Delden JJM, Agyepong I, Grobbee DE, Edwin A, Klipstein-Grobusch K, van der Graaf R. The willingness to participate in biomedical research involving human beings in low- and middle-income countries: a systematic review. Trop Med Int Health 2019; 24:264-279. [PMID: 30565381 PMCID: PMC6850431 DOI: 10.1111/tmi.13195] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives To systematically review reasons for the willingness to participate in biomedical human subjects research in low‐ and middle‐income countries (LMICs). Methods Five databases were systematically searched for articles published between 2000 and 2017 containing the domain of ‘human subjects research’ in ‘LMICs’ and determinant ‘reasons for (non)participation’. Reasons mentioned were extracted, ranked and results narratively described. Results Ninety‐four articles were included, 44 qualitative and 50 mixed‐methods studies. Altruism, personal health benefits, access to health care, monetary benefit, knowledge, social support and trust were the most important reasons for participation. Primary reasons for non‐participation were safety concerns, inconvenience, stigmatisation, lack of social support, confidentiality concerns, physical pain, efficacy concerns and distrust. Stigmatisation was a major concern in relation to HIV research. Reasons were similar across different regions, gender, non‐patient or patient participants and real or hypothetical study designs. Conclusions Addressing factors that affect (non‐)participation in the planning process and during the conduct of research may enhance voluntary consent to participation and reduce barriers for potential participants.
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Affiliation(s)
- Joyce L Browne
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Connie O Rees
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johannes J M van Delden
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Irene Agyepong
- Ghana Health Service, Research and Development Division, Accra, Ghana.,Public Health Faculty, Ghana College of Physicians and Surgeons, Accra, Ghana
| | - Diederick E Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ama Edwin
- Department of Psychological Medicine and Mental Health, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rieke van der Graaf
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Harapan H, Mudatsir M, Yufika A, Nawawi Y, Wahyuniati N, Anwar S, Yusri F, Haryanti N, Wijayanti NP, Rizal R, Fitriani D, Maulida NF, Syahriza M, Ikram I, Fandoko TP, Syahadah M, Asrizal FW, Jamil KF, Rajamoorthy Y, Wagner AL, Groneberg DA, Kuch U, Müller R, Sasmono RT, Imrie A. Willingness to Participate and Associated Factors in a Zika Vaccine Trial in Indonesia: A Cross-Sectional Study. Viruses 2018; 10:E648. [PMID: 30453663 PMCID: PMC6266114 DOI: 10.3390/v10110648] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 12/27/2022] Open
Abstract
One of the crucial steps during trials for Zika and other vaccines is to recruit participants and to understand how participants' attitudes and sociodemographic characteristics affect willingness to participate (WTP). This study was conducted to assess WTP, its explanatory variables, and the impact of financial compensation on WTP in Indonesia. A health facility-based cross-sectional study was conducted in eleven regencies in the Aceh and West Sumatra provinces of Indonesia. Participants were recruited via a convenience sampling method and were interviewed. The associations between explanatory variables and WTP were assessed using a two-step logistic regression analysis. A total of 1,102 parents were approached, and of these 956 (86.8%) completed the interview and were included in analysis. Of those, 144 (15.1%) were willing to participate in a Zika vaccine trial without a financial compensation. In the multivariate analysis, WTP was tied to an age of more than 50 years old, compared to 20⁻29 years (odds ratio (OR): 5.0; 95% confidence interval (CI): 2.37⁻10.53), to being female (OR: 2.20; 95% CI: 1.11⁻4.37), and to having heard about Zika (OR: 2.41; 95% CI: 1.59⁻3.65). Participants' WTP increased gradually with higher financial compensation. The rate of WTP increased to 62.3% at the highest offer (US$ 350.4), and those who were still unwilling to participate (37.7%) had a poorer attitude towards childhood vaccination. This study highlights that pre-existing knowledge about Zika and attitudes towards childhood vaccination are important in determining community members being willing to participate in a vaccine trial. Financial incentives are still an important factor to enhance participant recruitment during a vaccine trial.
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Affiliation(s)
- Harapan Harapan
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
- Tropical Disease Centre, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
- Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA 6009, Australia.
| | - Mudatsir Mudatsir
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
- Tropical Disease Centre, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
- Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
| | - Amanda Yufika
- Department of Family Medicine, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
| | - Yusuf Nawawi
- Department of Family Medicine, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
| | - Nur Wahyuniati
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
| | - Samsul Anwar
- Department of Statistics, Faculty of Mathematics and Natural Sciences, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
| | - Fitria Yusri
- School of Medicine, Malikussaleh University, Lhokseumawe, Aceh 24352, Indonesia.
| | - Novi Haryanti
- Community Health Centre of Meurah Mulia, North Aceh, Aceh 24372, Indonesia.
| | | | - Rizal Rizal
- Bunda Hospital, Lhokseumawe, Aceh 24351, Indonesia.
| | - Devi Fitriani
- Community Health Centre of Teunom, Aceh Jaya, Aceh 23653, Indonesia.
| | | | - Muhammad Syahriza
- Department of Public Health and Community Medicine, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
| | - Ikram Ikram
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
| | - Try Purwo Fandoko
- Community Health Centre of Gunung, Padang Panjang, West Sumatera 27122, Indonesia.
| | - Muniati Syahadah
- Community Health Centre of Lima Kaum, Tanah Datar, West Sumatera 27211, Indonesia.
| | | | - Kurnia F Jamil
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
- Department of Internal Medicine, School of Medicine, Syiah Kuala University, Banda Aceh, Aceh 23111, Indonesia.
| | - Yogambigai Rajamoorthy
- Department of Economics, Faculty of Accountancy and Management, Universiti Tunku Abdul Rahman, Selangor 43000, Malaysia.
| | - Abram Luther Wagner
- Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA.
| | - David Alexander Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main 60323, Germany.
| | - Ulrich Kuch
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main 60323, Germany.
| | - Ruth Müller
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main 60323, Germany.
- Unit of Medical Entomology, Institute of Tropical Medicine, Antwerp 2000, Belgium.
| | - R Tedjo Sasmono
- Eijkman Institute for Molecular Biology, Jakarta 10430, Indonesia.
| | - Allison Imrie
- School of Biomedical Sciences, University of Western Australia, Nedlands, WA 6009, Australia.
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Langford AT, Larkin K, Resnicow K, Zikmund-Fisher BJ, Fagerlin A. Understanding the Role of Message Frames on African-American Willingness to Participate in a Hypothetical Diabetes Prevention Study. JOURNAL OF HEALTH COMMUNICATION 2017; 22:647-656. [PMID: 28749729 DOI: 10.1080/10810730.2017.1339146] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The objective of this research was to evaluate the impact of message framing (e.g., highlighting health disparities vs. progress toward reducing disparities) on willingness to enroll in a hypothetical research study. African-American (AA, n = 1513) and White (n = 362) adults completed an online survey about diabetes, health behaviors including physical activity, and attitudes about research. AA participants were randomized to view a general message (same message as provided to all White participants) or 1 of 4 alternate messages that framed the need for people to participate in research in terms of race and/or health disparities. Among AAs, there were no differences in willingness to enroll in the study by message frame. However, individual characteristics including younger age, female sex, attitudes about research, a sense of obligation, and community responsibility were significant predictors of willingness to enroll in the study. AA participants who received the general message were equally willing as White participants to enroll in the study. Highlighting race and health disparities in study recruitment materials may not be needed to increase interest among AAs. Factors beyond race appear to be stronger motivators for participation. Unlike previous research, racial framing did not suppress motivation to enroll in our hypothetical study.
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Affiliation(s)
- Aisha T Langford
- a Department of Population Health , New York University , New York , NewYork , USA
| | - Knoll Larkin
- b Department of Oncology , Wayne State University , Detroit , Michigan , USA
| | - Ken Resnicow
- c Department of Health Behavior and Health Education , University of Michigan , Ann Arbor , Michigan , USA
| | - Brian J Zikmund-Fisher
- c Department of Health Behavior and Health Education , University of Michigan , Ann Arbor , Michigan , USA
| | - Angela Fagerlin
- d Salt Lake City VA Center for Informatics Decision Enhancement and Surveillance , Salt Lake City , Utah , USA
- e Department of Population Health Sciences , University of Utah , Salt Lake City , Utah , USA
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Kimble KMK, Wiener RL. Equal Protection versus Free Speech Rights: When Gains Loom Larger than Losses. APPLIED COGNITIVE PSYCHOLOGY 2016. [DOI: 10.1002/acp.3247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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12
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Balls-Berry JE, Hayes S, Parker M, Halyard M, Enders F, Albertie M, Pinn V, Radecki Breitkopf C. The Effect of Message Framing on African American Women's Intention to Participate in Health-Related Research. JOURNAL OF HEALTH COMMUNICATION 2016; 21:527-533. [PMID: 27077665 PMCID: PMC4898191 DOI: 10.1080/10810730.2015.1103333] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study examined the effect of message framing on African American women's intention to participate in health-related research and actual registration in ResearchMatch (RM), a disease-neutral, national volunteer research registry. A community-engaged approach was used involving collaboration between an academic medical center and a volunteer service organization formed by professional women of color. A self-administered survey that contained an embedded message framing manipulation was distributed to more than 2,000 African American women attending the 2012 national assembly of The Links, Incorporated. A total of 391 surveys were completed (381 after exclusion: 187 containing the gain-framed message and 194 containing the loss-framed message). The majority (57%) of women expressed favorable intentions to participate in health-related research, and 21% subsequently enrolled in RM. The effect of message framing on intention was moderated by self-efficacy. There was no effect of message framing on RM registration; however, those with high self-efficacy were more than 2 times as likely as those with low self-efficacy to register as a potential study volunteer in RM (odds ratio = 2.62, 95% confidence interval [1.29, 5.33]). This investigation makes theoretical and practical contributions to the field of health communication and informs future strategies to meaningfully and effectively include women and minorities in health-related research.
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Affiliation(s)
- Joyce E Balls-Berry
- a Department of Health Sciences Research , Mayo Clinic , Rochester , Minnesota , USA
| | - Sharonne Hayes
- b Department of Cardiovascular Diseases, Mayo Clinic , Rochester , Minnesota , USA
| | - Monica Parker
- c The Links, Incorporated , Washington , DC , USA
- d Emory University School of Medicine , Atlanta , Georgia , USA
| | - Michele Halyard
- c The Links, Incorporated , Washington , DC , USA
- e Department of Radiation Oncology , Mayo Clinic , Scottsdale , Arizona , USA
| | - Felicity Enders
- a Department of Health Sciences Research , Mayo Clinic , Rochester , Minnesota , USA
| | - Monica Albertie
- a Department of Health Sciences Research , Mayo Clinic , Rochester , Minnesota , USA
| | - Vivian Pinn
- c The Links, Incorporated , Washington , DC , USA
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Lambert DN, Bishop LE, Guetig S, Frew PM. A formative evaluation of social media campaign to reduce adolescent dating violence. JMIR Res Protoc 2014; 3:e64. [PMID: 25405494 PMCID: PMC4260010 DOI: 10.2196/resprot.3546] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/13/2014] [Accepted: 09/01/2014] [Indexed: 12/24/2022] Open
Abstract
Background The Emory Jane Fonda Center implemented the Start Strong Atlanta social marketing campaign, “Keep It Strong ATL”, in 2007 to promote the development of healthy adolescent relationships and to foster the prevention of adolescent dating abuse among 11-14 year olds. Objective A formative evaluation was conducted to understand whether messages directed at the target audience were relevant to the program’s relationship promotion and violence prevention goals, and whether the “Web 2.0” social media channels of communication (Facebook, Twitter, YouTube, Flickr, Tumblr, and Pinterest) were reaching the intended audience. Methods Mixed methodologies included qualitative interviews and a key informant focus group, a cross-sectional survey, and web analytics. Qualitative data were analyzed using constant comparative methodology informed by grounded theory. Descriptive statistics were generated from survey data, and web analytics provided user information and traffic patterns. Results Results indicated that the Keep It Strong ATL social marketing campaign was a valuable community resource that had potential for broader scope and greater reach. The evaluation team learned the importance of reaching adolescents through Web 2.0 platforms, and the need for message dissemination via peers. Survey results indicated that Facebook (ranked 6.5 out of 8) was the highest rated social media outlet overall, and exhibited greatest appeal and most frequent visits, yet analytics revealed that only 3.5% of “likes” were from the target audience. These results indicate that the social media campaign is reaching predominantly women (76.5% of viewership) who are outside of the target age range of 11-14 years. Conclusions While the social media campaign was successfully launched, the findings indicate the need for a more focused selection of communication channels, timing of media updates to maximize visibility, balancing message tone and delivery, and incorporating differentiated messaging for the target audiences. Collaboration with parents and community partners is also emphasized in order to expand the campaign’s reach and create more channels to disseminate relationship promotion and dating violence prevention messaging to the intended audience.
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Affiliation(s)
- Danielle N Lambert
- Emory University Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, GA, United States
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Dong Y, Shen X, Guo R, Liu B, Zhu L, Wang J, Zhang L, Sun J, Zhang X, Xu J. Willingness to participate in HIV therapeutic vaccine trials among HIV-infected patients on ART in China. PLoS One 2014; 9:e111321. [PMID: 25372044 PMCID: PMC4221013 DOI: 10.1371/journal.pone.0111321] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 09/30/2014] [Indexed: 01/17/2023] Open
Abstract
Background More and more HIV therapeutic vaccines will enter clinical trials; however, little is known about the willingness to participate (WTP) in HIV therapeutic vaccine trials among HIV-positive individuals. Objective To investigate the WTP in HIV therapeutic vaccine trials among Chinese HIV-infected patients. Methods We conducted a cross-sectional survey on HIV-positive inpatients and outpatients at Shanghai Public Health Center. A total of 447 participants were recruited into this study. Following an introduction with general information on HIV therapeutic vaccine and its potential effectiveness and side effects, each participant completed a questionnaire in a self-administered form. The questionnaires covered demographics, high-risk behaviors, clinical characteristics and willingness to participate in HIV therapeutic vaccine trial. Results The overall willingness to participate in HIV therapeutic vaccine trials was 91.5%. Interestingly, multivariate logistic regression analyses demonstrated that the willingness was higher for those sexually infected by HIV (odds ratio [OR]: 4.36; 95% confidence interval [CI]: 1.53–12.41), diagnosed as HIV-1 infection for greater than 5 years (OR: 7.12, 95% CI: 1.83–27.76), and with the presence of infectious complications (OR: 2.75; 95% CI: 1.02–7.45). The primary reason for participation was to delay or reduce antiretroviral treatment (ART) and to avoid ART side effects (76.6%), and then followed by delaying disease progression (74.9%), increasing immune response to suppress opportunistic infections (57.7%) and preventing the development of drug resistance (37.1%). Reasons for unwillingness to participate mainly included concern for safety (37.0%), lack of knowledge on therapeutic vaccine (33.3%), and satisfaction with ART effectiveness (22.2%). Conclusions The WTP in HIV therapeutic vaccine trials was high among HIV-infected Chinese patients. HIV+ subjects who acquired infection through sexual contact and who were diagnosed for more than 5 years may represent a good candidate population for enrollment in therapeutic vaccine trials.
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Affiliation(s)
- Yuan Dong
- Shanghai Public Health Clinical Center and Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education/Health, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaoxing Shen
- Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland, United States of America
| | - Ruizhang Guo
- Shanghai Public Health Clinical Center and Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education/Health, Shanghai Medical College, Fudan University, Shanghai, China
| | - Baochi Liu
- Shanghai Public Health Clinical Center and Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education/Health, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lingyan Zhu
- Shanghai Public Health Clinical Center and Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education/Health, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jing Wang
- Shanghai Public Health Clinical Center and Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education/Health, Shanghai Medical College, Fudan University, Shanghai, China
| | - Linxia Zhang
- Shanghai Public Health Clinical Center and Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education/Health, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jun Sun
- Shanghai Public Health Clinical Center and Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education/Health, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaoyan Zhang
- Shanghai Public Health Clinical Center and Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education/Health, Shanghai Medical College, Fudan University, Shanghai, China
- State Key Laboratory for Infectious Disease Prevention and Control, China CDC, Beijing, China
- * E-mail: (JX); (XZ)
| | - Jianqing Xu
- Shanghai Public Health Clinical Center and Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education/Health, Shanghai Medical College, Fudan University, Shanghai, China
- State Key Laboratory for Infectious Disease Prevention and Control, China CDC, Beijing, China
- * E-mail: (JX); (XZ)
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Van 't Riet J, Cox AD, Cox D, Zimet GD, De Bruijn GJ, Van den Putte B, De Vries H, Werrij MQ, Ruiter RAC. Does perceived risk influence the effects of message framing? A new investigation of a widely held notion. Psychol Health 2014; 29:933-49. [PMID: 24579986 DOI: 10.1080/08870446.2014.896916] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Health-promoting messages can be framed in terms of the beneficial consequences of healthy behaviour (gain-framed messages) or the detrimental consequences of unhealthy behaviour (loss-framed messages). An influential notion holds that the perceived risk associated with the recommended behaviour determines the relative persuasiveness of gain- and loss-framed messages. This 'risk-framing hypothesis', as we call it, was derived from prospect theory, has been central to health message framing research for the last two decades, and does not cease to appeal to researchers. The present paper examines the validity of the risk-framing hypothesis. We performed six empirical studies on the interaction between perceived risk and message framing. These studies were conducted in two different countries and employed framed messages targeting skin cancer prevention and detection, physical activity, breast self-examination and vaccination behaviour. Behavioural intention served as the outcome measure. None of these studies found evidence in support of the risk-framing hypothesis. We conclude that the empirical evidence in favour of the hypothesis is weak and discuss the ramifications of this for future message framing research.
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Affiliation(s)
- Jonathan Van 't Riet
- a Department of Communication Science, Behavioural Science Institute , Radboud University Nijmegen , Nijmegen , The Netherlands
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Frew PM, Saint-Victor DS, Owens LE, Omer SB. Socioecological and message framing factors influencing maternal influenza immunization among minority women. Vaccine 2014; 32:1736-44. [PMID: 24486366 DOI: 10.1016/j.vaccine.2014.01.030] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/18/2013] [Accepted: 01/14/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE A suboptimal level of seasonal influenza vaccination among pregnant minority women is an intractable public health problem, requiring effective message resonance with this population. We evaluated the effects of randomized exposure to messages which emphasize positive outcomes of vaccination ("gain-frame"), or messages which emphasize negative outcomes of forgoing vaccination ("loss-frame"). We also assessed multilevel social and community factors that influence maternal immunization among racially and ethnically diverse populations. STUDY DESIGN Minority pregnant women in metropolitan Atlanta were enrolled in the longitudinal study and randomized to receive intervention or control messages. A postpartum questionnaire administered 30 days postpartum evaluated immunization outcomes following baseline message exposure among the study population. We evaluated key outcomes using bivariate and multivariate analyses. RESULTS Neither gain- [OR=0.5176, (95% CI: 0.203,1.322)] nor loss-framed [OR=0.5000, 95% CI: (0.192,1.304)] messages were significantly associated with increased likelihood of immunization during pregnancy. Significant correlates of seasonal influenza immunization during pregnancy included healthcare provider recommendation [OR=3.934, 95% CI: (1.331,11.627)], use of hospital-based practices as primary source of prenatal care [OR=2.584, 95% CI: (1.091,6.122)], and perceived interpersonal support for influenza immunization [OR=3.405, 95% CI: (1.412,8.212)]. CONCLUSION Dissemination of vaccine education messages via healthcare providers, and cultivating support from social networks, will improve seasonal influenza immunization among pregnant minority women.
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Affiliation(s)
- Paula M Frew
- Emory University School of Medicine, Department of Medicine, Division of Infectious Diseases, Decatur, GA, United States; Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, GA, United States.
| | - Diane S Saint-Victor
- Emory University School of Medicine, Department of Medicine, Division of Infectious Diseases, Decatur, GA, United States; Emory University, Rollins School of Public Health, Hubert Department of Global Health, Atlanta, GA, United States
| | - Lauren E Owens
- Emory University School of Medicine, Department of Medicine, Division of Infectious Diseases, Decatur, GA, United States; Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, United States
| | - Saad B Omer
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, United States
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