Health inequities are influenced by social determinants at both individual and neighborhood levels. The literature is limited with respect to neighborhood-level socioeconomic inequalities and health-related outcomes among American Indian and/or Alaska Native (AI/AN) people in the US. We surveyed 907 AI/AN people aged 18 years and older seen at five organizations. Socioeconomic characteristics of neighborhoods were quantified using the area deprivation index, with the top 30

BACKGROUND:Developing optimal health communication strategies about COVID-19 and vaccines requires an understanding of the health literacy level of populations, trusted sources of information, and perceptions of COVID-19 messaging. We examined how health literacy is related to knowledge about COVID-19 among American Indian and Alaska Native (AI/AN) peoples. METHODS:We surveyed 788 AI/AN peoples at five Tribal health organizations between January and May 2021. We assessed health literacy using a 4-item health literacy index, and knowledge of COVID-19 in three domains: protection against contracting COVID-19; contracting COVID-19, and clinical manifestations of contraction. Questions also included rating trust of COVID-19 information sources and perceptions of messaging. RESULTS:Participants had a high level of knowledge about COVID-19; however, health literacy was not significantly associated with any domain of COVID-19 knowledge. Participants perceived the most trusted source of COVID-19-related health information to be health professionals, followed by health clinics. Social media was the least trusted source of information. Tribal sources of information were rated on average higher quality than non-tribal sources. CONCLUSIONS:AI/AN peoples had high levels of accurate knowledge about COVID-19 regardless of assessed health literacy. Information sources should include Tribal-led organizations and health professionals to increase uptake of COVID-19 messaging.

PurposeAmerican Indian and Alaska Native (AI/AN) peoples face disproportionate health risks. Understanding how AI/ANs seek out information can inform effective campaigns design that can help address these risks. We investigate preferred communication sources, health information seeking behavior (HISB), self-efficacy, perceived importance of health information, and prevention orientation of American Indians and Alaska Natives (AI/ANs).DesignWe administered a survey at 3 cultural events.SettingThe National Tribal Health Conference in Bellevue, the University of Washington Winter and Spring Powwows in Seattle.SubjectsParticipants (N = 344) of the survey included people from tribes throughout the US, particularly from northwestern tribes.AnalysisIndependent samples t-tests and ANOVAs examined differences in HISB. Frequency analyses identified preferred health information. PROCESS tested the relationship between perceived importance and HISB, and moderation from prevention orientation and self-efficacy.ResultsPreferred health information source were doctor (M = 3.5), the internet (M = 3.32) and friends/relatives (M = 3.11). Females demonstrated more HISB than males (P < .01). Individuals with a college degree or higher showed greater HISB (P < .001). AI/ANs living on reservations (M = 2.34, SD = 1.53) preferred newspapers for health information more than those in metropolitan (M = 1.64, SD = .13) or rural areas (M = 1.45, SD = .16, P < .05). Perceived importance is a robust positive factor that predicts HISB (b = .48, t(315) = 9.67, P < .001).ConclusionThis study offers advice for scholars and practitioners to design messages to increase accessibility of health information.

This study examines the portrayal of contaminants in pilot whale in Faroese media from 1977 to 2022. Pilot whale is integral to Faroese culture but has come under scrutiny due to health concerns linked to contaminants. Given the role of media in shaping public understanding of health risks, our research assesses how four main Faroese media outlets have presented the issue to the public. We analysed 227 newspaper articles, radio, and television news stories, focusing on contaminants, mentioning of scientific studies or researchers, the demographic groups identified as at risk, and mentions of government advisories on whale meat consumption. Our findings indicate a predominant portrayal of contaminants as harmful, with a substantial emphasis on the risks to developing foetuses and children. Scientific studies, particularly those led by the Department of Occupational Medicine and Public Health in the Faroe Islands, were frequently cited. Despite varying advisories over the years, the narrative consistently highlighted the health risks associated with pilot whale consumption. This study contributes to broader discussions on environmental health communication by illustrating how localised media coverage can shape public risk perception, offering insights relevant to communities facing similar dilemmas between traditional hunting and public health.

There is a critical need to strengthen science-society relationships-especially with historically marginalized communities-if we are to better and more equitably manage complicated, intertwined, global challenges at the intersection of environment, health, equity, and well-being. Community-engaged science, which focuses on shared leadership and mutual benefit in scientific partnership with communities, has the potential to transform science, communities, and even society. Despite this promise, however, community-engaged science is not always transformative. Presentations and discussions at the 5th National Academies Science Communication Colloquium demonstrated the importance of creating structures, practices, and a culture of science engagement that prioritizes listening and learning from communities. Based on presentations at the colloquium, research publications, and our own experiences, we share a set of evidence-informed principles that are common to successful community-engaged science across many contexts: respect, humility, listening, reciprocity, mutuality, and reflexivity. We also offer steps the scientific community can take to advance and improve the transformative practice of community-engaged science as part of a productive ecosystem of scientific activities: evolving norms and culture, integrating community science into current systems, building incentives and structures to support community-engaged science, developing a workforce skilled in community engagement, and investing in a coordinated research-to-practice agenda.

Media exposure can shape audience perceptions surrounding novel innovations, such as artificial intelligence (AI), and could influence whether they share information about AI with others online. This study examines the indirect association between exposure to AI in the media and information sharing about AI online. We surveyed 567 US citizens aged 18 and older in November 2020, several months after the release of Open AI’s transformative GPT-3 model. Results suggest that AI media exposure was related to online information sharing through psychological proximity to the impacts of AI and positive AI performance expectancy in serial mediation. This positive indirect association became stronger the more an individual perceived society to be changing due to new technology. Results imply that public exposure to AI in the media could significantly impact public understanding of AI, and prompt further information sharing online.

Football upholds traditional masculine ideals of toughness, aggression, and dominance despite the risk of serious injury. This study uses a qualitative framework to understand why non-scholarship National Collegiate Athletic Association (NCAA) Division III college football players risk their health through athletics. Interviews revealed that players go through two stages of risk reassessment wherein the player strongly weighs the costs and benefits of playing versus quitting. Once football players continue past the second stage, virtually nothing will prevent them from continuing their involvement with the team. They have determined that the costs of playing a high-contact sport with a high risk of injury are worth the friendships, forming a "Brotherhood" among the teammates. This paper discusses the implications for athletes, coaches, administrators, and health professionals.

The development and dissemination of health messaging is a critical component of reducing health disparities. Participants (n = 87) from a human biomonitoring study in six Dene communities responded to a survey about health communication regarding contaminants. The survey included questions on awareness of health messages and risk perceptions related to country foods and contaminants. The vast majority of participants reported eating country foods (99%) and heard that country foods had beneficial nutrients (90%). Seventy per cent of respondents had heard or seen messages about fish with high levels of mercury, and 60% had concerns about the safety or quality of country foods they consumed. Respondents who reported decreasing the number of fish they ate since hearing the messages about fish and mercury had lower (p = 0.04) mercury concentration in hair, compared to those who had not heard the messages. However, no differences in hair mercury were observed for respondents who reported to have changed their fishing location, chosen smaller fish or eaten less predatory fish since hearing the messages. Results indicate the need to examine reasons for self-reported behaviour changes, in addition to awareness. The conclusions of this study can inform the development of messaging and risk management decisions about contaminants within Indigenous populations.

Arctic populations are amongst the highest exposed populations to long-range transported contaminants globally, with the main exposure pathway being through the diet. Dietary advice is an important immediate means to address potential exposure and help minimize adverse health effects. The objective of this work is to enable easier access to dietary advice and communication guidance on contaminants with a focus on the Arctic. This manuscript is part of a special issue summarizing the Arctic Monitoring and Assessment Programme’s Assessment 2021: Human Health in the Arctic. The information was derived with internet searches, and by contacting relevant experts directly. Results include risk communication efforts in European Arctic countries, effectiveness evaluation studies for several Arctic countries, experience of social media use, and the advantages and challenges of using social media in risk communication. We found that current risk communication activities in most Arctic countries emphasize the importance of a nutritious diet. Contaminant-related restrictions are mostly based on mercury; a limited amount of dietary advice is based on other contaminants. While more information on effectiveness evaluation was available, specific information, particularly from Arctic countries other than Canada, is still very limited.

Development and amplification of effective, culturally resonant, trustworthy, and evidence-based public health communication are urgently needed. Research evidence, theory, and practical experience from within and beyond the interdisciplinary field of health communication are well-positioned to help public health authorities, researchers, and advocates navigate the complex societal challenges that influence health and well-being in global contexts. This review offers a broad overview of the field, considers what constitutes "effectiveness" versus "effects" in public health communication, and describes core concepts of public health communication as a process rather than a product. We review domains and dominant foci of public health communication research, articulate challenges for health communication to advance health and social equity and address mis-/disinformation, and offer practical guidance on message development, audience segmentation, multilevel intervention, and evaluation of communication programs. We conclude by identifying important questions for future public health communication research, interventions, and funding.

sociated risk factors. Studies have highlighted the potential for social media to reach underserved populations, suggesting these platforms can be used to disseminate health information tailored for diverse and hard-to-reach populations. Little is known, how -ever, about the use of social media among American Indian and Alaska Native populations. The objective of this cross-sectional study is to better understand the use of social media platforms to disseminate information across these populations. Our team sur-veyed 429 American Indian and Alaska Native adults attending cultural events in Washington State on their use of various types of social media. We used logistic regressions to assess participant use of Twitter, Snapchat, Facebook, and Instagram as related to participant demographics, including age, gender, education, and their place of residence (on-reservation, rural off-reservation areas, or large metropolitan areas). Findings showed that Facebook was used by more participants than other platforms (79%), followed by Instagram (31%). Nearly half of participants used only one social media platform (48%). Age was negatively associated with using Instagram (0.8 OR, 95% CI: 0.7, 0.9) and Snapchat (0.6 OR, 95% CI: 0.5, 0.7). College education was associated with higher odds of using an additional social media platform compared to those without any college education (2.0 OR, 95% CI: 1.1, 3.6). Most participants used social media platforms, which suggests these platforms may be a useful tool in disseminating information to American Indian and Alaska Native peoples. Further research should document how social media can be used to effectively dis-seminate risk and health information and assess whether it can influence health knowledge and behaviors among these popula-tions. Patients, health professionals, and communities use social media to communicate information about health determinants and as-

Patients, health professionals, and communities use social media to communicate information about health determinants and associated risk factors. Studies have highlighted the potential for social media to reach underserved populations, suggesting these platforms can be used to disseminate health information tailored for diverse and hard-to-reach populations. Little is known, however, about the use of social media among American Indian and Alaska Native populations. The objective of this cross-sectional study is to better understand the use of social media platforms to disseminate health information in this population. We surveyed 429 American Indian and Alaska Native adults attending cultural events in Washington State on their use of various types of social media. We used logistic regressions to assess participant use of Twitter, Snapchat, Facebook, and Instagram as related to participant demographics, including age, gender, education, and residence (either reservation, rural area but not a reservation, or large metropolitan area). Facebook was used by more participants (79%) than other platforms, followed by Instagram (31%); Nearly half of participants used only one social media platform (48%). Age was negatively associated with using Instagram (0.8 OR, 95% CI: 0.7, 0.9) and Snapchat (0.6 OR, 95% CI: 0.5, 0.7). College education was associated with a higher odds of using an additional social media platform compared to those without any college education (2.0 OR, 95% CI: 1.1, 3.6). Most participants used social media platforms, suggesting that they may be a useful tool in disseminating health and health risk information to American Indian and Alaska Native people. Further research should document how social media can be used to effectively disseminate risk and health information across the life course and assess whether it can influence health knowledge and behaviors among this populations.

Artificial intelligence (AI) is changing industries globally. It is also having both positive and negative effects on society. People often learn about technology through media, and so news about AI could have significant impacts on public perceptions of AI. Employing agenda-setting theory, we explore associations between attention to AI news and attitudes about AI. Results of a survey suggest attention to AI news content is associated with perceived economic risks associated with AI. Higher levels of perceived economic risk were associated with greater fear tied to AI. Higher levels of fear were associated with holding more negative perceptions of AI but only among people with lower incomes. We found a negative indirect association between attention to AI news content and negative perceptions of AI through perceived AI risk and fear in serial mediation. This negative indirect association was stronger among people with lower incomes. We discuss the potential effects of media on the public understanding of AI.

Lead ammunition is commonly used to hunt waterfowl and other wildlife in the Arctic. Hunting with lead is problematic because the toxicant can be transferred to the consumer. Therefore, it is critical to evaluate perceptions and awareness of the risks associated with using lead ammunition among Arctic populations. Results of the Nunavik Child Development Study (a longitudinal health study gathering information on health and well-being among Inuit in Nunavik, Canada) included advice to eliminate the use of lead ammunition in hunting practices. We surveyed 112 Nunavik residents (93 women; 18 men) about their awareness of lead related messages, use of lead ammunition and risk perceptions about contaminants. Sixty-seven participants (59.8%) reported there was an active hunter in their household. We found that only 27% of participants had heard or seen the messages about reducing lead ammunition. After participants viewed the Nunavik Child Development Study messages about lead, 44% stated they would stop using lead ammunition. However, 28% indicated that they would continue using lead ammunition. We conclude that, while messages had an overall positive effect, further study is required to understand why people continue to use lead ammunition.

The COVID-19 pandemic disproportionately affected Native American people and communities across the United States. Despite unequal losses during the pandemic, Native Americans have high vaccination rates. We provide insight into perspectives of COVID-19 and vaccinations through in-depth interviews with Native Americans. Through this research, we provide a holistic view of how Native Americans perceive vaccines by pairing Indigenous perspectives of risk and the Health Belief Model. We discuss the importance of tribal sovereignty in developing health communication strategies, and the need for messaging that is trusted and culturally appropriate.

Indigenous populations residing in the Arctic commonly rely on country foods for nutritional, spiritual and cultural benefits. However, some food sources have become contaminated with heavy metals or persistent organic pollutants. As a result of these contaminants, it is critical that risk communicators develop effective and culturally appropriate health messages about the risks and benefits of eating country foods. To address this challenge in the Canadian Inuit region of Nunavik, a working group was formed to advance risk management, determine health advisories, and communicate recommendations about local country foods. The Nunavik Child Development Study (NCDS) Communications Working Group included local hunters, educators, health care professionals, researchers, and communicators, among others. In-depth interviews with members of the NCDS Communications Working Group were completed to provide insight into the risk management approach and how communication messages and materials were developed and delivered. Study results reveal the importance of including members of the Inuit population affected by the risk in the design and dissemination of communication material. In addition, researchers and healthcare professionals were able to: (1) access important local knowledge; (2) better understand the perceptions of the populations; and (3) assess behaviors that contributed to contaminant exposure. By incorporating multiple perspectives and including members of the population in the affected region in the decision-making process, there was greater consensus in risk management and communication design. We discuss the benefits and challenges of utilizing an approach that includes participatory elements, and how lessons from this case can contribute to participatory risk communication literature more broadly. This study ultimately provides insight into how using elements of a participatory approaches to risk management and communication - that considers different experiences, knowledges, and skills - can result in potentially more culturally relevant health advisories and risk communication campaigns.

COVID-19 vaccinations are the primary tool to end the pandemic. However, vaccine hesitancy continues to be a barrier to herd-immunity in the United States. American Indians (AI) often have higher levels of distrust in western medicine and lower levels of satisfaction with health care when compared to non-Hispanic Whites. Yet AIs have high COVID-19 vaccination rates. We discuss factors that influence AI risk perceptions of COVID-19 vaccinations including the impact of COVID-19 on AI Elders, community, and culture. We conclude with future research needs on vaccination communication and how culturally congruent communication campaigns may have contributed to high COVID-19 vaccination rates.

Amanda Boyd is Métis and Dane-zaa (an Indigenous person of Canada) and comes from a rural family of farmers and ranchers that live in northern Alberta, Canada. This background strongly influenced her career and fueled her passion to improve the health and well-being of rural and Indigenous populations. She completed a Master’s degree from the University of Alberta in Rural Sociology, and later a PhD from the University of Calgary in Communication Studies with a Graduate Certificate in Energy and Environmental Systems. Her major research interests are risk perceptions, science communication, energy policy, and Indigenous health. This encompasses issues such as Alzheimer’s disease, hypertension, risks from technology, and food chain exposures from contaminants. She is currently an Associate Professor in the Edward R. Murrow College of Communication, and affiliated faculty at the Institute for Research and Education to Advance Community Health at Washington State University. She works with rural and Indigenous communities to develop the tools and theory needed to create effective, culturally relevant risk communication strategies.

Developing artificial intelligence (AI) equitably necessitates understanding how nonexperts conceptualize and share news about technoscientific risk. We examine a model predicting AI information sharing online from an interaction of framing strategies, through psychological proximity to the impacts of AI and perceived AI risk. A panel of N = 412 participants were exposed to either a control message; or one of four manipulated messages related to AI risks. Contrary to expectations, thematically framed explicit risk news primed psychological proximity compared to both a control message and episodic frame condition. Meanwhile, episodic explicit risk frames did not prime psychological proximity over a control message. These results contest the notion that episodic frames should be associated with psychological proximity to a risk over more general framing strategies. Our results support prior research suggesting that where risk-news primes psychological proximity, the decrease in distance is in-turn associated with greater risk perception and increased likelihood of news sharing online.

Introduction:American Indian and Alaska Native (AI/AN) people infrequently participate in Alzheimer's disease (AD) research, despite the rapidly increasing population of AI/AN people aged 65 and older. Methods:We surveyed 320 adults who identified as AI/AN at two Native-focused events and used ordinary least squares regression and logistic regression models to test associations between demographic factors and perceived risk of AD, knowledge about AD, and willingness to participate in research, along with preferred source of AD information. Results:Willingness to participate in research was highest among those living in a city versus reservation and associated with perceived personal risk for AD. Health professionals and the internet were preferred sources of information about AD. Discussion:These hypothesis-generating results provide insight into perceptions of AD and willingness to participate in research. Conclusions could inform development of AD recruitment strategies for AI/ANs and influence participation in AD research.