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Addressing COVID-19 Misinformation

Addressing COVID-19 Misinformation

Misinformation online can confuse consumers and influence people to dismiss vital public health advice. Health Chat team members from Klein Buendel, the University of Connecticut, and Colorado State University have published analyses of misinformation from a social media study in the Journal of Public Health Management and Practice. The purpose of the study was to examine how an epidemiological procedure for monitoring, diagnosing, and responding quickly to misinformation among members of a Facebook group may have affected debate and dropout among group members.

Facebook group participants were 303 mothers of adolescent daughters. The Facebook group was administered by a community manager. The social media feed varied the source of information in posts on four topics: social distancing, COVID-19 vaccines, digital and media literacy, and family communication about COVID-19. Mothers received one social media post each weekday in three randomly assigned Facebook private groups, covering all four topics plus one additional post on a positive non-pandemic topic to promote broad engagement. Posts in the three groups had the same messages but differed by links to information from government agencies, near-peer parents, or news media sources in the post.

The community manager identified misinformation in mothers’ comments. Misinformation was defined as COVID-19 information in opposition to recommendations from the Centers for Disease Control and Prevention, National Institutes of Health, and/or World Health Organization. Misinformation took several forms. In some comments, mothers directly presented false information or expressed their own negative opinions or opposition toward COVID-19 prevention. In other comments, mothers presented misinformation indirectly.

Research methods and analyses are detailed in the Journal of Public Health Management and Practice paper. Most misinformation comments were in response to posts about vaccination, followed by non-pharmaceutical interventions, digital and media literacy, and family communication. The responsive epidemiological protocol exposed the mothers to credible information and appeared to prevent debate and dropout of Facebook group members.

This research was funded by a grant and supplement from the National Cancer Institute (CA192652). Dr. David Buller from Klein Buendel and Dr. Sherry Pagoto from the University of Connecticut were the project’s Multiple Principal Investigators. Additional authors on this publication include Joseph Divito from the University of Connecticut; Dr. Kim Henry from Colorado State University; and Dr. Barbara Walkosz, Dr. Gill Woodall, Julia Berteletti, and Alishia Kinsey from Klein Buendel.

Promoting Social Distancing and COVID-19 Vaccination in a Social Media Feed for Mothers

Promoting Social Distancing and COVID-19 Vaccination in a Social Media Feed for Mothers

The Health Chat team from Klein Buendel, the University of Connecticut, Colorado State University, and East Tennessee State University has published findings from a health communication study in the journal JMIR Infodemiology. The purpose of the study was to examine how the source of health information shared via a Facebook social media feed might impact behavioral intentions related to practicing social distancing or accepting COVID-19 vaccination. The Facebook group participants were mothers of adolescent daughters. The social media feed varied the source of information in posts on four topics: social distancing, COVID-19 vaccines, digital and media literacy, and family communication about COVID-19. The information sources were government agencies, near-peer parents, and news media.

In summary, 303 mothers with adolescent daughters from a previous study testing a social media campaign on indoor tanning were recruited in January 2021 and enrolled in a randomized single-factor design (government agencies vs. near-peer parents vs. news media) evaluating the 9-week Facebook feed with four assessments at baseline and 3-week, 6-week, and 9-week follow-ups. Mothers received one social media post each day (Monday-Friday) in three randomly assigned Facebook private groups, covering all four topics plus one additional post on a positive non-pandemic topic to promote engagement. Posts in the three groups had the same messages but differed by links to information from government agencies, near-peer parents, or news media in the post. Views, reactions, and comments related to each post were counted to measure engagement with the messages. Mothers reported on social distancing and vaccine intentions for themselves and their daughters at the four assessment points.

Research methods and analyses are detailed in the JMIR Infodemiology paper. Nearly all mothers (98%) remained in the Facebook private groups throughout the 9-week trial period, and assessment completion rates were high. Analysis showed that social distancing behavior by mothers and daughters decreased over time but vaccine intentions increased. Decrease in social distancing by daughters was greater in the near-peer source group and lesser in the government agency group. The higher perceived credibility of the assigned information source increased social distancing and vaccine intentions. Mothers’ intentions to vaccinate themselves may have increased when they considered the near-peer source to be not credible. According to the authors, decreasing case counts, relaxation of government restrictions, and vaccine distribution during the study may explain the decreased social distancing and increased vaccine intentions.

This research was funded by a grant and supplement from the National Cancer Institute (CA192652). Dr. David Buller from Klein Buendel and Dr. Sherry Pagoto from the University of Connecticut were the project’s Multiple Principal Investigators. Additional authors on this publication include Joseph Divito from the University of Connecticut; Dr. Kim Henry from Colorado State University; Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University; and Dr. Barbara Walkosz, Dr. Gill Woodall, Julia Berteletti, and Alishia Kinsey from Klein Buendel.

Effects of Engagement with a Social Media Campaign to Reduce Indoor Tanning

Effects of Engagement with a Social Media Campaign to Reduce Indoor Tanning

A paper by Klein Buendel scientists, staff, and collaborators published in the Journal of Health Communication reports on a secondary analysis of engagement effects from a social media campaign. The campaign, called Health Chat, was aimed at reducing mothers’ permissiveness for indoor tanning (IT) by their teenage daughters.

In the study, over 800 mothers with daughters aged 14-17 were recruited in 34 states that did not ban IT by minors under age 18 for a randomized trial. Follow-up assessments were completed at the end of the intervention (12 months) and six months after that (18 months). Daughters’ baseline and follow-up responses were analyzed also. Mothers received a Facebook feed on adolescent health topics that included posts about preventing IT (intervention) or prescription drug misuse (control).

Engagement was measured by extracting reactions (such as like or sad) and comments posted by mothers to the campaign posts. Overall, 76.4% of posts received a reaction and/or comment. Mothers who engaged with IT posts were less permissive of daughters’ IT immediately at the end of the campaign and six months after the intervention than mothers who did not engage with the posts.

Social media is a large part of the media diets of many parents and show some promise for health behavior change interventions. Social media posts need to both reach and engage parents, especially in social media like Facebook whose algorithm prioritizes posts from feeds that receive more views, reactions, and comments. This is to ensure that the posts appear in participants’ news feeds so well-crafted health communication can influence them. The authors conclude, however, that more work is needed on strategies to engage individuals with social media posts in the context of improving public policies that restrict minors’ access to IT facilities.

This research was funded by a grant and supplement from the National Cancer Institute (CA192652; Dr. David Buller and Dr. Sherry Pagoto, Multiple Principal Investigators). Collaborating authors include Dr. Kimberly Henry from Colorado State University; Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University; Jessica Bibeau from the University of Connecticut; and Dr. Barbara Walkosz and Julia Berteletti from Klein Buendel.

Promoting Social Distancing and COVID-19 Vaccine Intentions

Promoting Social Distancing and COVID-19 Vaccine Intentions

Dr. David Buller, Klein Buendel’s Director of Research, presented findings from a supplemental campaign to the Health Chat social media intervention for mothers and their teenage daughters at the 72nd Annual Conference of the International Communication Association in Paris, France, May 26-30, 2022.

Dr. David Buller Presenting at ICA

The COVID-19 pandemic is the most severe public health crisis in the past 100 years. To control the pandemic, the Centers for Disease Control and Prevention (CDC) advised Americans to practice non-pharmaceutical interventions (social distancing) and federal and state governments mounted an unprecedented biomedical endeavor to develop and distribute vaccines and boosters.

Social media is playing a large role in disseminating information on the COVID-19 pandemic, but it is also being used to spread misinformation that affects prevention measures such as social distancing and vaccine acceptance.

A sample of 303 mothers of teen daughters were enrolled in a 3 (information source) x 4 (assessment period) randomized factorial trial from January to March 2021 to evaluate effects of information sources in a social media campaign addressing non-pharmaceutical interventions (social distancing), COVID-19 vaccinations, media literacy, and mother-daughter communication about COVID-19. Mothers received the 9-week campaign in one of three Facebook private groups in which posts contained information and links to government agencies, near-peer parents, or news media.

Mothers reported social distancing behavior and COVID-19 vaccine intentions for self and daughter in baseline and 3-, 6-, and 9-weeks post-randomization assessments.

In intent-to-treat analyses, social distancing behavior by mothers and daughters decreased over time but vaccine intentions increased. The decrease in social distancing by daughters was greater in the near-peer source group and lesser in the government source group. Higher perceived credibility of assigned information source increased social distancing and vaccine intentions. Decreasing case counts, relaxation of government restrictions, and vaccine distribution during the study may explain the decreased social distancing and increased vaccine intentions.

Campaign planners may be more effective when selecting information sources that audiences consider credible when promoting COVID-19 prevention as no source was more credible in general.

This research was funded by a grant and supplement from the National Cancer Institute (CA192652; Dr. David Buller and Dr. Sherry Pagoto, Multiple Principal Investigators). Authors on this presentation include Dr. Sherry Pagoto, Joseph Divito, Christie Idiong, and Haley Troy from the University of Connecticut; Dr. Kim Henry from Colorado State University; Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University; and Dr. David Buller, Dr. Barbara Walkosz, Dr. Gill Woodall, Julia Berteletti, and Alishia Kinsey from Klein Buendel.

Mothers’ Reactions to a COVID-19 Prevention Facebook Group

Mothers’ Reactions to a COVID-19 Prevention Facebook Group

Social media platforms have been a tool for disseminating recommendations and updates on COVID-19. Christie Idiong from the University of Connecticut presented qualitative findings from the COVID-19 Health Chat program at the 43rd Annual Meeting & Scientific Sessions of the Society of Behavioral Medicine in Baltimore, MD, April 6-9 2022.

The COVID-19 Health Chat program was a 9-week Facebook-delivered intervention to provide mothers of teenage daughters with messages promoting non-pharmaceutical interventions and vaccines, teaching digital and media literacy, and supporting family communication around COVID-19.

After the intervention, the research team conducted semi-structured interviews with 30 mothers. Mothers were asked: 1) “What did you like the most about being in the Facebook group?”, 2) “What did you like least?”, 3) “What did you think of the information sources used?”, and 4) “How would you compare the quality of the information you received in this Facebook group relative to other sources of information you’ve encountered during the pandemic?”.

Responses to each question were double coded and summarized. When asked what they liked most about the program, the most common response was the reliable information provided, followed by interacting with group members. When asked what they liked least, the most common responses indicated they did not dislike anything about the group, disliked extreme opinions from other mothers, and lacked interest in the information. When asked about sources used in the Facebook feed, the most common responses said sources were credible and helpful, followed by not recalling the sources, and sources being biased. When asked how the information in the group compared to other sources they encountered in the pandemic, most participants responded it was about the same or better quality, followed by not remembering the content. Most participants indicated that information they received was reliable, helpful, and of similar or better quality than what they had previously encountered.

Future research is needed to understand how individuals in the general population determine a source of information is reliable and how prevention communication on other health topics can be disseminated with similar success.

This research is funded by a grant and supplement from the National Cancer Institute (CA192652; Dr. David Buller and Dr. Sherry Pagoto, Multiple Principal Investigators). Authors on this poster presentation include Dr. Sherry Pagoto, Christie Idiong, Joseph Divito, Kaylei Arcangel, and Haley Troy from the University of Connecticut; and Julia Berteletti, Dr. Barbara Walkosz, Dr. Gill Woodall, Alishia Kinsey, and Dr. David Buller from Klein Buendel.

COVID-19 Social Media Feed for Mothers and Teen Daughters

COVID-19 Social Media Feed for Mothers and Teen Daughters

Social media is a key channel for information on COVID-19 from government agencies, near-peers, and news media. The Health Chat team developed a social media feed that varied type of information source in posts on social distancing, COVID-19 vaccines, digital and media literacy, and family communication. Dr. David Buller from Klein Buendel presented findings from the COVID-19 social media feed at the 43rd Annual Meeting & Scientific Sessions of the Society of Behavioral Medicine in Baltimore, MD, April 6-9 2022.

A total of 303 mothers with adolescent daughters from a previous study testing a social media campaign on indoor tanning were recruited in January 2021 and enrolled in a randomized single-factor design (government agencies v. near-peer parents v. news media) of a 9-week Facebook feed with four assessments (baseline, 3-week, 6-week, and 9-week follow-ups). The feed contained five posts per week based on social cognitive theory, transportation theory, and diffusion of innovation theory. Mothers reported on social distancing and vaccine intentions for self and daughters.

Using intention-to-treat analyses, mothers’ reports of social distancing by self and daughter declined over the 9-weeks. Daughters’ social distancing declined faster in the near-peer condition but less quickly in the government condition. Vaccine intentions increased over the nine weeks in all experimental condition. Baseline intentions seemed to moderate effect of condition on change in intentions. Mothers with initially high vaccine intentions (relative to moderate intentions) assigned to the government condition reported a less steep increase in intentions over time and had slightly lower intentions to vaccinate at the end of the study. Baseline credibility of the assigned information source predicted increased vaccine intentions. However, in the near-peer condition, mothers who assigned them lower as opposed to higher credibility showed increased vaccine intentions.

Theory-based posts emphasizing information from government agencies may have provided credible counterarguments against local jurisdictions relaxing pandemic restrictions that slowed declines in daughters’ social distancing. The near-peer sources may have been influential with mothers who did not expect them to convey the credible arguments supporting vaccines which they did in the experimental feed, consistent with violations of expectations theory in persuasive communication.

This research is funded by a grant and supplement from the National Cancer Institute (CA192652; Dr. David Buller and Dr. Sherry Pagoto, Multiple Principal Investigators). Authors on this presentation include Dr. Sherry Pagoto and Joseph Divito from the University of Connecticut; Dr. Kim Henry from Colorado State University; and Dr. David Buller, Dr. Barbara Walkosz, Dr. Gill Woodall, Julia Berteletti, and Alishia Kinsey from Klein Buendel.

Dr. David Buller Presenting at SBM
Risks and Protective Factors for Non-medical Prescription Drug Use among Teen Girls

Risks and Protective Factors for Non-medical Prescription Drug Use among Teen Girls

Prevention efforts can be informed by learning more about the risks and protective factors for adolescent non-medical use of prescription drugs (NMUPD). A study was conducted with data collected from the Health Chat study to look at the potential influence of maternal factors, social norms, and perceptions of risk and availability on NMUPD by adolescent females. Health Chat was a social media intervention to help reduce mothers’ permissiveness toward their teen daughters’ indoor tanning behavior in an effort to prevent skin cancer. Mother-daughter communication on other health topics was also analyzed. Methods and findings for this NMUPD analysis have been published online in the journal, Drugs: Education, Prevention and Policy.

Multiple logistic regression was used for analysis. Daughters’ past NMUPD and inclination for future NMUPD were regressed onto descriptive norms for friend use, perceived drug accessibility and risk of harm from use, daughter age, mothers’ disapproval about use, mothers’ past NMUPD and inclination for future NMUPD, and the mother-daughter relationship quality. Akaike weights and lasso regressions were also estimated to evaluate the relative importance of each correlate. Higher descriptive norms for friend use, older age, and mothers’ inclination for NMUPD were risk factors for daughters’ NMUPD. Protective factors were a closer mother-daughter relationship and mothers’ disapproving attitudes towards NMUPD. The authors conclude that friend descriptive norms, mother-daughter relationship quality, and mothers’ attitudes about NMUPD could be explored as key targets for prevention efforts.

This research was funded by a grant and supplement from the National Cancer Institute (CA192652; Dr. David Buller and Dr. Sherry Pagoto, Multiple Principal Investigators). The lead author is Gemma Wallace from Colorado State University. Collaborating authors include Dr. Katie Baker and Dr. Stephanie Mathis from East Tennessee State University; Dr. Kimberly Henry from Colorado State University; Dr. Sherry Pagoto from the University of Connecticut; and Dr. David Buller and Julia Berteletti from Klein Buendel. 

Mutual Influences of Mothers’ and Daughters’ Mental Health on the Closeness of their Relationship

Mutual Influences of Mothers’ and Daughters’ Mental Health on the Closeness of their Relationship

A Health Chat study published in the Journal of Child and Family Studies examined intra- and interpersonal associations between poor mental health and mother–daughter relationship closeness in a sample of 467 dyads. Health Chat was a social media intervention designed to reduce mothers’ permissiveness toward their teen daughters’ indoor tanning behavior. It also addressed other adolescent health topics, such as vaccination, alcohol, and physical activity.

An Actor–Partner Interdependence Model was used to examine bidirectional processes between mothers and their teenage daughters. The independent variable was self-reported poor mental health and the dependent variable was relationship closeness. Communication satisfaction was also examined as a potential interpersonal mediator of the pathway between poor mental health and relationship closeness.

Daughters’ self-reported poor mental health negatively predicted their own perception of closeness as well as mothers’ perception of closeness. In addition, there was evidence that perceived communication may help explain both the actor effect (one’s own poor mental health on one’s own perception of closeness) and the partner effect (partner’s poor mental health on one’s own perception of closeness).

Detailed methods and results are presented in the publication. Results suggest that when daughters’ mental health is poor, relationship closeness as perceived by mother and daughter may be weakened, and that this effect may in part be explained by poor communication between mother and daughter. The authors concluded that strategies to promote family communication, especially for families experiencing mental health problems, may aid in the development of closer mother–daughter relationships.

This research was funded by a grant and supplement from the National Cancer Institute (CA192652; David Buller and Sherry Pagoto, Multiple Principal Investigators). Additional collaborating authors include Hyanghee Lee (lead author) and Kimberly Henry from Colorado State University; Katie Baker and Joel Hillhouse from East Tennessee State University; Jessica Bibeau from the University of Connecticut; and Barbara Walkosz and Julia Berteletti from Klein Buendel. 

Mothers and Teenage Daughters: HPV Vaccination Information via Social Media

Mothers and Teenage Daughters: HPV Vaccination Information via Social Media

Dr. David Buller, Klein Buendel’s Director of Research, and his coauthors have published results from the Health Chat Project in the online journal, Frontiers in Digital Health. Health Chat was designed as a social media intervention to reduce mothers’ permissiveness toward their teen daughters’ indoor tanning behavior. It also addressed other adolescent health topics, including human papillomavirus vaccination.

“Parents acquire information about human papillomavirus (HPV) vaccines online and encounter vaccine-critical content, especially on social media, which may depress vaccine uptake,” according to the authors. To help address vaccine hesitancy and misinformation, the authors employed a Facebook-delivered adolescent health campaign targeting mothers with posts on HPV vaccination. The study examined the relationship between mothers’ comments and reactions to posts about HPV and any change in their self-reports of having their daughters vaccinated.

The online publication describes the study’s hypotheses, social media health intervention, research methods, results, communication strategies, and limitations. The behavioral research was guided by social cognitive theory, transportation theory, and diffusion of innovations theory. In summary, mothers commented both positively and negatively toward HPV vaccine-related posts. Also, vaccinations rates increased from baseline, through 12-month and 18-month follow-up assessments.

This research was funded by a grant and supplement from the National Cancer Institute (CA192652; Dr. David Buller and Dr. Sherry Pagoto, Multiple Principal Investigators). Collaborating authors include Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University; Dr. Kimberly Henry from Colorado State University; Jessica Bibeau from the University of Connecticut; Kelsey Arroyo from the University of Florida; and Dr. Barbara Walkosz and Julia Berteletti from Klein Buendel.