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      Texas Public Agencies’ Tweets and Public Engagement During the COVID-19 Pandemic: Natural Language Processing Approach

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          Abstract

          Background

          The ongoing COVID-19 pandemic is characterized by different morbidity and mortality rates across different states, cities, rural areas, and diverse neighborhoods. The absence of a national strategy for battling the pandemic also leaves state and local governments responsible for creating their own response strategies and policies.

          Objective

          This study examines the content of COVID-19–related tweets posted by public health agencies in Texas and how content characteristics can predict the level of public engagement.

          Methods

          All COVID-19–related tweets (N=7269) posted by Texas public agencies during the first 6 months of 2020 were classified in terms of each tweet’s functions (whether the tweet provides information, promotes action, or builds community), the preventative measures mentioned, and the health beliefs discussed, by using natural language processing. Hierarchical linear regressions were conducted to explore how tweet content predicted public engagement.

          Results

          The information function was the most prominent function, followed by the action or community functions. Beliefs regarding susceptibility, severity, and benefits were the most frequently covered health beliefs. Tweets that served the information or action functions were more likely to be retweeted, while tweets that served the action and community functions were more likely to be liked. Tweets that provided susceptibility information resulted in the most public engagement in terms of the number of retweets and likes.

          Conclusions

          Public health agencies should continue to use Twitter to disseminate information, promote action, and build communities. They need to improve their strategies for designing social media messages about the benefits of disease prevention behaviors and audiences’ self-efficacy.

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          Most cited references36

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          A meta-analysis of the effectiveness of health belief model variables in predicting behavior.

          The Health Belief Model (HBM; Rosenstock, 1966) was constructed to explain which beliefs should be targeted in communication campaigns to cause positive health behaviors. The model specifies that if individuals perceive a negative health outcome to be severe, perceive themselves to be susceptible to it, perceive the benefits to behaviors that reduce the likelihood of that outcome to be high, and perceive the barriers to adopting those behaviors to be low, then the behavior is likely for those individuals. A meta-analysis of 18 studies (2,702 subjects) was conducted to determine whether measures of these beliefs could longitudinally predict behavior. Benefits and barriers were consistently the strongest predictors. The length of time between measurement of the HBM beliefs and behavior, prevention versus treatment behaviors, and drug-taking regimens versus other behaviors were identified as moderators of the HBM variables' predictive power. Based on the weakness of two of the predictors, the continued use of the direct effects version of the HBM is not recommended.
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            Crisis and emergency risk communication as an integrative model.

            This article describes a model of communication known as crisis and emergency risk communication (CERC). The model is outlined as a merger of many traditional notions of health and risk communication with work in crisis and disaster communication. The specific kinds of communication activities that should be called for at various stages of disaster or crisis development are outlined. Although crises are by definition uncertain, equivocal, and often chaotic situations, the CERC model is presented as a tool health communicators can use to help manage these complex events.
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              Public Health and Online Misinformation: Challenges and Recommendations

              The internet has become a popular resource to learn about health and to investigate one's own health condition. However, given the large amount of inaccurate information online, people can easily become misinformed. Individuals have always obtained information from outside the formal health care system, so how has the internet changed people's engagement with health information? This review explores how individuals interact with health misinformation online, whether it be through search, user-generated content, or mobile apps. We discuss whether personal access to information is helping or hindering health outcomes and how the perceived trustworthiness of the institutions communicating health has changed over time. To conclude, we propose several constructive strategies for improving the online information ecosystem. Misinformation concerning health has particularly severe consequences with regard to people's quality of life and even their risk of mortality; therefore, understanding it within today's modern context is an extremely important task.
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                Author and article information

                Contributors
                Journal
                JMIR Public Health Surveill
                JMIR Public Health Surveill
                JPH
                JMIR Public Health and Surveillance
                JMIR Publications (Toronto, Canada )
                2369-2960
                April 2021
                26 April 2021
                26 April 2021
                : 7
                : 4
                : e26720
                Affiliations
                [1 ] Department of Communication Texas A&M University College Station, TX United States
                [2 ] Jack J Valenti School of Communication University of Houston Houston, TX United States
                [3 ] Department of Computer Science Rice University Houston, TX United States
                [4 ] School of Biomedical Informatics University of Texas Health Science Center at Houston Houston, TX United States
                [5 ] Department of Journalism and Mass Communication North Carolina A&T State University Greensboro, NC United States
                Author notes
                Corresponding Author: Lu Tang ltang@ 123456tamu.edu
                Author information
                https://orcid.org/0000-0002-1850-1511
                https://orcid.org/0000-0003-3146-8645
                https://orcid.org/0000-0003-2545-6293
                https://orcid.org/0000-0002-2312-1206
                https://orcid.org/0000-0002-4151-4230
                https://orcid.org/0000-0003-2731-829X
                https://orcid.org/0000-0001-7754-1890
                Article
                v7i4e26720
                10.2196/26720
                8078375
                33847587
                cf23db0d-9cc5-4424-8cde-2bd03d5297ba
                ©Lu Tang, Wenlin Liu, Benjamin Thomas, Hong Thoai Nga Tran, Wenxue Zou, Xueying Zhang, Degui Zhi. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 26.04.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on https://publichealth.jmir.org, as well as this copyright and license information must be included.

                History
                : 22 December 2020
                : 5 January 2021
                : 20 March 2021
                : 9 April 2021
                Categories
                Original Paper
                Original Paper

                covid-19,public health agencies,natural language processing,twitter,health belief model,public engagement,social media,belief,public health,engagement,communication,strategy,content analysis,dissemination

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