Within the theory of planned behavior, ambivalent attitudes (that are simultaneously positive and negative) can weaken the link between attitudes, intentions and behavior. This study examined whether perceived healthiness of fast-food brands would weaken the relationship between positive emotional attitudes toward fast-food brands and diet quality. In Study 1, university students in Australia completed the study in a lab; Study 2 (pre-registered) was completed by US-based participants online. In both experiments, participants rated major fast food and beverage brand logos on liking and perceived healthiness, completed dietary questionnaires (DFS, RED-13) and self-reported BMI and demographic data. Sensitivity analyses excluded brands marketed as "healthy." Consistently across both Australian and American samples, dietary fat and sugar intake was predicted by both higher liking ratings of fast-food brand logos and reward-based eating styles. Contrary to expectations, these effects were not significantly moderated by perceived healthiness of the brands. Fast-food brands that were more liked were also perceived to be healthier by those consuming more dietary fat and sugar. These results point to a possible contribution of food brand marketing and brand loyalty in shaping consumer behavior.
The COVID-19 pandemic challenged Dutch and Flemish municipalities to provide clear, understandable instructions about preventive measures. Each municipality designed its own icons to convey these preventive measures. We conducted two studies to examine both the characteristics of these icons and their comprehension by the public. First, a content analysis revealed a predominance of instructional over prohibitive icons, and many did not contain text. More concrete and dynamic icons were semantically closer to the intended message, while those with text tended to be visually complex. Second, we tested the comprehension of eight icons among Dutch and Flemish citizens. Results indicated that three of the icons did not meet ISO-standard for comprehension. Perceived clarity turned out the be the strongest predictor of accurate interpretation. Additionally, lower education levels and non-native language backgrounds were associated with higher rates of misunderstanding. Misinterpretations were linked to color choice, complexity, and visual salience. Together, these findings provide insights for designing clear and effective visual instructions to support public understanding during health crises.
Parents of children with rare diseases face unique challenges due to scarce medical expertise and limited information sources. Social media, particularly Facebook, have become a vital (and sometimes the only) space for parents to access information, share experiences, and find emotional support. This study examined how parents of children with an ultra-rare genetic condition [FOXP1] engage with a Facebook group. Semi-structured interviews were conducted with 19 parents across eight countries and analyzed using thematic analysis. Based on the results, we developed the "Phased Social Media Engagement in Rare Disease Caregiving" model. The model illustrates how informational, emotional, and psychological needs may vary across the caregiving journey and under different circumstances. This model delineates three phases of engagement: (1) Frantic, characterized by intensive information seeking and urgent reassurance seeking commonly described around the time of diagnosis; (2) Selective and Saturated, in which parents, having surpassed an information threshold, used Facebook more strategically for targeted problem-solving and advocacy, while consciously avoiding distressing content; and (3) Mentoring, in which some parents guided and reassured newly diagnosed families, deriving meaning and identity through supporting others. Results highlight both the benefits and risks of online peer support groups, underscoring the need for healthcare providers to acknowledge these groups and help parents navigate information overload and emotional triggers.
This article uses Diffusion of Innovations (DOI) theory to predict audience engagement with healthy recipes from a campaign designed to promote physical activity and fruit and vegetable consumption. Across three studies (Study 1 N = 543; Study 2 N = 805; Study 3 N = 300), participants in online surveys viewed one social media post (randomly selected from larger pools) promoting a healthy recipe. After viewing the social media post, participants rated their intention to click on the link, make the recipe, and share the recipe post then rated that recipe on four DOI theory attributes: relative advantage, compatibility with their lifestyle, complexity, and trialability. In each study, Ordinary Least Squares regression was used to examine the relationship between DOI theory attributes and each intention measure. Results consistently demonstrated that a recipe's perceived relative advantage and perceived compatibility were significant predictors of intention to click on, make, or share the recipe. Complexity and trialability were rarely significant predictors of intentions. These results can be used to inform both message development and message testing strategies for nutrition-focused campaigns, as nutrition interventions that are seen as being higher in relative advantage and compatibility may be more readily adopted by priority populations.
As wearable health technologies become increasingly important in preventive healthcare and personal health management, understanding the factors that drive user adoption has become a critical issue for researchers and practitioners. Although previous studies have examined wearable technology adoption from either health-related or technology-related perspectives, limited research has integrated these perspectives within a comprehensive framework. This study develops an integrated framework based on the Health Belief Model (HBM), the Technology Acceptance Model (TAM), and self-efficacy to investigate factors influencing users' attitudes and intentions toward wearable health devices. Data were collected via an online survey of 385 Taiwanese adults, and structural equation modeling (SEM) was employed to test the proposed relationships. Results show that perceived health threat, perceived usefulness, and self-efficacy significantly influence user attitudes, which in turn affect behavioral intention, while perceived ease of use exerts an indirect effect. Barriers such as low perceived need and limited technological confidence were identified as adoption inhibitors. The findings indicate that both health-related perceptions and technology-related evaluations jointly influence wearable technology adoption decisions. The findings provide an integrated framework that combines health belief and technology acceptance perspectives, offering practical implications for healthcare communicators, technology developers, marketers, and policymakers to enhance user engagement, improve device design, and promote preventive health behaviors through wearable healthcare technologies.
Most images depicting larger bodies or obesity in pregnancy are negative, such as promoting stereotypes of being physically inactive or eating unhealthily. Constantly viewing larger bodies or obesity in a negative light will contribute to advancing weight stigmatizing perspectives. Images are a powerful way to influence public health perceptions, and the aim of this work was to collect and share positive stories and depictions of obesity or larger bodies in pregnancy. Eligible participants were ≥ 18 years of age, had obesity or a larger body in pregnancy and could communicate in English. Participants were prompted to share a positive or meaningful image from their pregnancy and detail the story behind their selection. Textual and visual thematic analyses were completed. Eleven participants shared a photograph and story which were organized into two themes: 1. Proud of their pregnant body; 2. Social connections in pregnancy. Participant stories emphasized wanting to share with others how gratified they felt for having a healthy pregnancy. Photos were taken with or by loved ones, highlighting the importance of social connections throughout their pregnancy. These findings may inspire the development of image banks and the overall visual representation of obesity and larger bodies in pregnancy to better communicate and convey inclusion.
This study examines how sadness and the risk direction of corrective messages jointly shape responses to health misinformation. In a 2 (emotion: neutral vs. sadness) × 2 (risk direction: risk-increasing e‑cigarette vs. risk-decreasing mRNA vaccine) online experiment with U.S. adults (N = 797), participants viewed a misinformation post, completed an autobiographical emotion induction and then received a text-only correction. Corrections reduced belief in false claims and lowered sharing overall. Sadness had no main effect but interacted with risk direction: in the risk-increasing e‑cigarette condition, sadness was associated with larger belief reductions, whereas in the risk-decreasing vaccine condition, sadness attenuated belief reduction. Belief predicted sharing intention, and the only reliable pathway from sadness to sharing operated indirectly via belief in the risk-decreasing condition. The findings highlight risk direction as a structural property of corrective messages and show that sadness can support or undermine corrections, depending on how risk is repositioned.
Drawing on narrative persuasion theories and Conceptual Metaphor Theory, this study investigates how different metaphors in mental illness (MI) narratives influence cognition, emotion, and anti-stigma behaviors among individuals without personal MI experience. Using a 4 (metaphor use: war, journey, conversation, literal) × 2 (protagonist-reader similarity: high vs. low) between-subjects experimental design (N = 522), the study finds that metaphor effectiveness highly depends on protagonist-reader similarity. Compared with literal narratives, war and journey metaphors increased hope and subsequently MI social interaction and MI help-seeking intentions, but only when protagonist-reader similarity was high. When similarity was low, these metaphors reduced identification and discouraged both behavioral outcomes. In contrast, the conversation metaphor demonstrated desirable effects across similarity conditions: Under high similarity, it increased hope, which predicted stronger anti-stigma behavioral intentions. Under low similarity, it enhanced MI help-seeking through greater cognitive elaboration or directly increased MI social interaction intention. Together, these findings suggest that incorporating self-talk and inward conversation may be particularly valuable in metaphorical MI narratives, while also providing preliminary evidence that metaphorical MI narratives can produce stigma-reduction effects when aligned with audience characteristics.
Given the constant pressure to improve patient experience, this study investigates how physicians' nonverbal communication (NVC) shapes patients' perceptions of service quality and patient satisfaction, while accounting for the role of gender in physician-patient interactions. To isolate the role of NVC, a 2 × 2 × 2 factorial design was employed, featuring manipulated kinesics (open vs. closed) and physician gender (male vs. female), with patient gender included as a measured factor. Data from 200 participants (50 per scenario) revealed that open kinesics significantly enhanced both service quality and patient satisfaction. Although physician gender alone had no direct impact, the interaction between physician and patient gender was significant for patient satisfaction. These findings emphasize the role of kinesic cues as a key dimension of NVC in shaping patient experience.
Cancer is the second leading cause of death worldwide. With increasing reliance on online media for health information, the proliferation of cancer-related misinformation poses a significant threat to informed health decisions. Therefore, this study investigated the presence of misinformation in cancer reporting via South African online news media.A content analysis was conducted on 431 cancer-related articles published between 2013 and 2022 across the eight most popular South African online news sites. The findings provide insight into how misinformation manifests in online cancer reporting. While most articles adhered to generally high journalistic standards, exaggerated claims about miracle cures, herbal remedies, and alternative treatments were common and often poorly substantiated. Encouragingly, many articles also actively challenged false claims, highlighting the media's potential role in promoting evidence-based health communication.This study provides one of the first empirical baselines for understanding cancer-related misinformation in South African online news media. It underscores the need to uphold high standards of journalistic integrity and accuracy in health reporting, while highlighting the crucial role of healthcare professionals, researchers, and institutions in supporting evidence-based coverage. The findings further emphasize the importance of continuous monitoring and improvement of media practices, as well as addressing systemic barriers that limit meaningful engagement between researchers and the media in efforts to counter misinformation.
Mental health messaging is designed to promote well-being, reduce stigma, and encourage help-seeking. Repeated exposure to such messaging, however, can lead to message fatigue, a motivational state that undermines attention and elaboration even when messages remain memorable. We present two studies that explore how message fatigue affects attention, elaboration, and perceived effectiveness of mental health messages among college students. In Study 1, a demographically representative sample of 218 US college students viewed a series of mental health infographics. Self-reported elaboration, message evaluation, and memory was assessed following exposure. In study 2, 70 participants pre-screened for high and low levels of message fatigue completed an eye-tracking laboratory experiment focusing on visual attention during exposure. Across both studies, message fatigue significantly reduced elaboration which, in turn, predicted lower message effectiveness. Further analysis showed that diminished elaboration mediated the effect of message fatigue on perceived message effectiveness. Eye-tracking data showed that high fatigue participants exhibited shorter fixation durations than low fatigue participants across all design elements (e.g. image, text, graph), indicating reduced visual attention. Findings highlight how mental health campaigns can lose persuasive force through reduced elaboration and attention, informing creative and media strategies for managing message fatigue.
Extreme heat, driven by climate change, poses significant health risks, particularly for vulnerable populations such as older adults, infants, and individuals with chronic illnesses. Generative AI may help tailor and scale climate adaptation messages, including for extreme heat, to better support those at risk. This research aims to assess the ability of ChatGPT 4o and DALL-E-3 to create accurate, tailored, theory-based public health text- and image-based messages about extreme heat in Canada. The objectives of this research include: 1) to engineer prompts to develop text- and image-based generative AI outputs about extreme heat, 2) to evaluate the outputs, and 3) to explore the ability of generative AI to tailor outputs further using theory and best practices. A variety of prompts were developed and tested to evaluate ChatGPT 4o and DALL-E 3's ability to generate health messages. 31 generated text and 17 image outputs were evaluated for accuracy, literacy, bias, and alignment with health communication models/frameworks to evaluate their effectiveness in addressing the needs of heat-vulnerable populations. While most text outputs were accurate, none met the target of a grade 8 reading level. Messages often included direct heat impacts and protective actions, but fewer framed heat within climate change. Image outputs were generally accurate but lacked diversity, and two images reinforced stigma. These findings highlight both the potential and the limitations of generative AI in health communication, emphasizing the need for careful oversight to ensure accuracy, accessibility, and inclusivity.
This Global Forum article proposes “affordable health advice” as a complementary lens for understanding credibility and livability in digital health communication. Drawing on my previous research on Egyptian physician vloggers and using a recent Egyptian digital health controversy as an illustrative thread, the article argues that audiences do not evaluate health advice only through scientific validity, source expertise, trust, or health literacy. They may also assess whether advice appears possible to live with. The article identifies three dimensions of affordability: economic, cultural, and emotional. Economic affordability concerns whether advice appears financially attainable and sustainable in contexts where treatment, medication, testing, food, and long-term disease management impose substantial costs. Cultural affordability concerns whether advice speaks from within people’s everyday language, food practices, religious rhythms, humor, and classed realities. Emotional affordability concerns whether advice reduces the psychological burden of illness by promising hope, autonomy, and relief from chronic-patient identity. The article argues that health advice may gain credibility when it appears more compatible with lived realities than conventional recommendations, even when that advice is scientifically contested.
Traditional, complementary and integrative medicine (TCIM) use is widespread, particularly among individuals with chronic health conditions who are drawn to TCIM's holistic approach. This approach frequently involves educating users on lifestyle factors that may detrimentally impact their health outcomes. Consequently, the TCIM workforce holds much potential to facilitate public health promotion and education. However, little is known about the current healths literacy (HL) of TCIM users - a gap requiring focus to optimize the role of TCIM in preventive health efforts. This review aims to determine the level of HL reported by TCIM users and identify relationships between HL and TCIM use. A systematic literature search for eligible studies was conducted using five scientific databases: EMBASE, MEDLINE, CINAHL, AMED, and Scopus. All databases were searched from their inception to January 2024. All relevant observational studies on the HL of TCIM users were included. From the 23 included studies, mean HL scores among most participants fell into the "borderline-sufficient" or "moderate-high" categories. These scores ssuggest HL may be associated with, or result from, frequent interactions with TCIM practitioners or services. Several sociodemographic characteristics shared a positive relationship with HL and TCIM use, including higher socioeconomic status. This review captures the breadth of HL scores reported by TCIM users and aims to elucidate relationships between HL and TCIM use. By enhancing our understanding of the health knowledge within this population, public health policies, educational programs, and future research can be more effectively targeted to user needs.
Narrative-based fact-checking has been proposed as a promising strategy to improve the effectiveness of corrective messages, as narratives can lower reactance. However, less is known about whether the source of narrative correction shapes its effectiveness. As social media platforms increasingly adopt AI-based fact-checking tools, it is essential to understand how fact-checking strategies function in the age of AI. This study conducted an online between-subjects experiment testing the effects of fact-checking message format (statistical vs. narrative) and fact-checking source (human vs. AI) on counterarguing against fact-checking, perceived credibility of misinformation, and belief in misinformation. Results showed that narrative fact-checking reduced both counterarguing and perceived credibility of misinformation compared to statistical fact-checking, but it did not significantly reduce belief in misinformation. Furthermore, narrative fact-checking was more effective at reducing perceived credibility when delivered by a human rather than AI, whereas statistical fact-checking was more effective when delivered by AI rather than a human. These findings offer implications for social media platforms in tailoring fact-checking strategies based on message format and source.
The rapid spread of mis/disinformation has become a threat to public health. In response, the National Academies of Sciences, Engineering, and Medicine (NASEM) produced nine publications on this topic between 2020-2025. This study qualitatively analyzes and synthesizes these publications to examine how approaches to misinformation are articulated across levels and sectors. The most recent, a 2025 Consensus Study Report, served as a reference framework; its 13 formal recommendations guided deductive coding of proposed actions across the remaining publications, with inductive refinement of emergent themes. As a result, seven themes emerged: 1) community engagement, 2) tools and techniques to counter misinformation, 3) communication, 4) social media and online platforms, 5) collaboration, 6) journalism, and 7) other priorities. Across these themes, approaches are distributed, but unevenly developed, across individual, community, institutional, and technological levels, involving a wide range of actors. Taken together, these publications call for practical, audience-specific communication strategies grounded in trust-building efforts, with genuine community involvement. Future work should evaluate the effectiveness of proposed approaches while considering the evolving regulatory, political, and social context in which misinformation persists.
Health misinformation on social media platforms is increasingly prevalent and spreads faster than truthful content. Belief in health misinformation, especially by allied health care professionals, carries detrimental risks to patient care. The purpose of this study was to examine the current state of evidence on pediatric allied health care professionals' susceptibility to health misinformation on social media. Four research databases were searched and PRISMA guidelines were followed to identify and screen articles for inclusion in this evidence-based systematic review. Quality appraisal using the Mixed Methods Appraisal Tool and the Center for Evidence-Based Medicine quality appraisal tool was conducted to determine final inclusion for review. Three articles met inclusion criteria for further analysis. Overall, susceptibility to health misinformation is multifaceted and there are many psychological, behavioral, and demographic factors that impact susceptibility to misinformation. Information source and trust, group identity, preexisting beliefs, and emotions surrounding the topic play a major role in susceptibility to misinformation. This study highlights factors that are known to influence susceptibility to health misinformation. Susceptibility to health misinformation can influence allied health professionals' adoption of beliefs and practices that do not otherwise align with research-based methods. However, no research to date has analyzed susceptibility of health misinformation specifically with allied health care professionals and additional research is warranted.
Health communication often faces a segmentation-intervention gap: psychographic segmentation identifies meaningful audience profiles, but these profiles are rarely translated into experimentally tested segment-specific messages. This study proposes and tests a segmentation-to-intervention pipeline that integrates Health Belief Model (HBM) diagnostics with generative artificial intelligence (GAI) for type 2 diabetes prevention. In Study 1 (N = 993), a two-step cluster analysis identified three HBM-based psychographic segments among at-risk adults. In Study 2 (N = 737), a randomized experiment tested AI-generated messages produced by Gemini 2.5 Pro to match each segment's HBM profile. Compared with a general message, AI-generated segment-specific messages increased preventive intentions at the aggregate level and within all three segments, suggesting broad persuasive benefits across psychologically distinct groups. Mediation analysis showed that AI personalization was associated with greater message elaboration, which in turn was linked to cognitive trust, affective trust, and preventive intention. Exploratory path results further suggested a direct association between elaboration and affective trust, extending existing models of human-AI trust. These findings demonstrate the feasibility of a scalable, theory-driven framework for precision health communication.
Public health crises depend on trusted community-based workers who interpret guidance, address local concerns, and help residents act under uncertainty. Existing crisis communication frameworks, including Crisis and Emergency Risk Communication (CERC) and Risk Communication and Community Engagement (RCCE), recognize the importance of community-centered approaches but offer limited guidance on what this work requires in practice. This study examined how community health workers (CHWs) serving Latine communities developed and applied communication competencies during and after the COVID-19 pandemic. We conducted two rounds of in-depth interviews with 41 CHWs in a large U.S. metropolitan area, capturing experiences across response and recovery contexts. Using thematic analysis with a hybrid deductive-inductive approach, we identified six communication competencies: (1) information seeking, sensemaking, and verification; (2) strategic communication and message design; (3) conversational and cultural interaction; (4) digital and media communication; (5) collaborative and team-based communication; and (6) system navigation and resource linkage. CHWs combined these competencies as coordinated practice rather than discrete skills. Findings extend CERC and RCCE by translating broad principles into teachable practices and provide a foundation for strengthening CHW training, supervision, and integration into emergency communication preparedness, particularly for linguistically and culturally diverse communities.
