Individuelle Werte in der strategischen Impfkommunikation: Bedeutung und Wirkung am Beispiel der HPV-Impfung

Impfungen gehören – nicht erst seit der Corona-Pandemie – zu den effizientesten und wichtigsten Maßnahmen zur Förderung der öffentlichen Gesundheit, indem Personen vor Infektionskrankheiten und deren Komplikationen und Folgeerkrankungen geschützt werden. Um die Impfakzeptanz zu steigern, nehmen gut aufbereitete Informationskampagnen einen wichtigen Stellenwert ein. Aktuelle wissenschaftliche Studien stellen dabei vermehrt die Ansprache individueller Werte in den Fokus, da nicht nur die öffentliche Impf-Diskussion stark von Werten geprägt ist, sondern auch die individuellen Werte der Bürger:innen zentral sind, um die Impfakzeptanz zu erklären. Indem nicht nur relevante Werte im Impfkontext identifiziert werden, sondern ebenfalls eine strategische Verknüpfung des Impfthemas mit Werten (sog. Value-Framing) erfolgt, sollen Individuen zum Handeln in Übereinstimmung mit diesen Werten motiviert werden. Aus diesem Grund verfolgt die Arbeit das Ziel, die Bedeutung von Werten für die strategische Impfkommunikation am Beispiel der HPV-Impfung genauer zu untersuchen. Hierfür wurden insgesamt drei sequenzielle, aufeinander aufbauende Studien im Mixed-Methods-Design durchgeführt. Aufgrund der geringen Evidenz zum Zusammenhang von Werten und dem Impfverhalten dienten teilstandardisierte Leitfadeninterviews zunächst dazu, die Relevanz und Kontextualisierung von Werten sowie zentrale Vorstellungen zu identifizieren. In einer standardisierten Online-Befragung wurde basierend darauf der Zusammenhang von Werten und den zentralen Determinanten des Impfverhaltens überprüft. Um die Wirkung einer wertebasierten Kommunikation zu untersuchen, wurde abschließend eine Online-Experimentalstudie durchgeführt. Die Ergebnisse zeigen, dass es kaum möglich ist, wertefrei zu kommunizieren. Daher sollte die Auswahl und Integration von Werten in Impf- und Gesundheitsinformationen aus Sicht von Kommunikator:innen gut durchdacht werden, um die anvisierten Ziele zu erreichen und nicht-intendierte Effekte einer wertebasierten Kommunikation zu vermeiden. Die Arbeit schließt dabei ein wichtige Forschungslücke und zeigt theoretische sowie praktische Implikationen auf

HPV-Impfverhalten erklären: Die Rolle von individuellen Werten in der Theory of Planned Behavior

Die HPV-Impfquote in Deutschland ist deutlich zu gering, weshalb neue evidenz-basierte Kommunikationsstrategien gefordert werden. Eine Möglichkeit zur Steigerung von Impfquoten bietet die Ansprache individueller Werte, da diese, wenn sie als Bezugsrahmen aufgespannt werden, die Wahrnehmung, Meinung und Einstellung zu einer Thematik beeinflussen können. Die vorliegende Studie entwickelte daher ein Modell, das individuelle Werte in die Theory of Planned Behavior integriert, um wichtige Werte im HPV-Impfkontext zu identifizieren. Zur Modell-Überprüfung wurde eine Online-Umfrage unter Eltern (N = 245) durchgeführt. Die Ergebnisse einer Strukturgleichungsmodellierung zeigen, dass Personen, die Machtwerte als wichtig empfanden, eine negativere Einstellung zur HPV-Impfung aufwiesen, was wiederum zu einer schwächeren Impfintention führte. Dies deutet darauf hin, dass Eltern ihre Kinder mitunter deshalb nicht impfen lassen, weil sie unerwünschte Impfreaktionen nicht kontrollieren können. Die Integration von Machtwerten in Impfinformationen kann somit einen Mehrwert bieten, um impfkritische Eltern von der HPV-Impfung zu überzeugen.The HPV vaccination rate in Germany is considerably too low. Therefore, new evidence-based communication strategies are needed. One way to increase vaccination rates is to address individual values, as these, when raised as a frame of reference, can influence perceptions, opinions, and attitudes. We developed a model that integrates individual values into the Theory of Planned Behavior to identify important values in the HPV vaccination context. An online survey of parents (N = 245) was conducted to verify the research model. Results of structural equation modeling showed that individuals who perceived power values as important had more negative attitudes toward HPV vaccination, which in turn led to weaker vaccination intention. This suggests that some parents may not vaccinate their children because they cannot control adverse vaccination reactions. Thus, integrating power values into health information may provide added value in convincing vaccine-critical parents to vaccinate their children against HPV

Effects of exemplars and base-rate information on online physician rating sites

In recent years, the number of users on online physician rating sites has increased continuously. According to exemplification theory, user comments have a strong influence on individual judgments. Visualized base-rate information can constrain these effects. This study examines the impact of exemplars and base-rate information regarding physician rating sites on the perception and evaluation of doctors, as well as participants’ behavioral intentions. To address this question, we conducted a 2 x 2 x 2 online experiment (N = 216). We developed eight alternative versions of a physician rating site, varying the valence of the exemplars (factor 1: positive/negative) and base-rate information (factor 2: positive/negative) and the type of presentation of the base-rate information (factor 3: bar graph/average grade). Our results show that the valence of both significantly influenced participants’ recall, evaluation and behavioral intentions. Furthermore, the negative bar graph led to a more accurate evaluation than the negative average grade. The strong impact of base-rate information limits the scope of exemplification effects in the context of physician online rating sites

Gesundheitsinformationsverhalten 65+: Erreichbarkeit älterer Zielgruppen

Background!#!The proportion of older adults among the population is constantly growing. At the same time, the risk of health problems increases with age. From a health promotion perspective, it is therefore important to reach this target group. The selection of media and communication channels should be based on media use and health information behavior of the target group. In this context, it may be necessary to segment the heterogeneous group of older adults into subgroups.!##!Objectives!#!The article provides current empirical data on the health information behavior of older adults in general and in particular subgroups. On this basis, adequate communication channels can be selected to address these groups.!##!Methods!#!First, 20 people participated in guided qualitative interviews. Second, a subsequent standardized telephone survey of 1001 randomly selected people aged 65 years and above was conducted.!##!Results!#!Older adults can best be reached via interpersonal and traditional mass media sources. Health-related media such as pharmacy magazines also play an important role, especially for people with chronic diseases. Furthermore, health professionals are also an important source of information for older adults with chronic diseases and a negative attitude towards aging. On the internet, men and people with a higher income are more likely to be reached.!##!Conclusions!#!Older adults in Germany are a heterogeneous target group. To reach them effectively, differences in the health information behavior of subtarget groups must be considered. Furthermore, the content and design of communication measures should also be evidence based

Intentions of Patients With Cancer and Their Relatives to Use a Live Chat on Familial Cancer Risk: Results From a Cross-Sectional Web-Based Survey

Memenga P, Baumann E, Lütke Lanfer H, et al. Intentions of Patients With Cancer and Their Relatives to Use a Live Chat on Familial Cancer Risk: Results From a Cross-Sectional Web-Based Survey. Journal of Medical Internet Research. 2023;25: e45198.BACKGROUND: An important prerequisite for actively engaging in cancer prevention and early detection measures, which is particularly recommended in cases of familial cancer risk, is the acquisition of information. Although a lot of cancer information is available, not all social groups are equally well reached because information needs and communicative accessibility differ. Previous research has shown that a live chat service provided by health professionals could be an appropriate, low-threshold format to meet individual information needs on sensitive health topics such as familial cancer risk. An established German Cancer Information Service is currently developing such a live chat service. As it is only worthwhile if accepted by the target groups, formative evaluation is essential in the course of the chat service's development and implementation.; OBJECTIVE: This study aimed to explore the acceptance of a live chat on familial cancer risk by patients with cancer and their relatives (research question [RQ] 1) and examine the explanatory power of factors associated with their intentions to use such a service (RQ2). Guided by the Extended Unified Theory of Acceptance and Use of Technology (UTAUT2), we examined the explanatory power of the following UTAUT2 factors: performance expectancy, effort expectancy, social influence, facilitating conditions, and habit, supplemented by perceived information insufficiency, perceived susceptibility, perceived severity, and cancer diagnosis as additional factors related to information seeking about familial cancer.; METHODS: We conducted a cross-sectional survey via a German web-based access panel in March 2022 that was stratified by age, gender, and education (N=1084). The participants are or have been diagnosed with cancer themselves (n=144) or have relatives who are or have been affected (n=990). All constructs were measured with established scales. To answer RQ1, descriptive data (mean values and distribution) were used. For RQ2, a blockwise multiple linear regression analysis was conducted.; RESULTS: Overall, 32.7% of participants were (rather) willing, 28.9% were undecided, and 38.4% were (rather) not willing to use a live chat on familial cancer risk in the future. A multiple linear regression analysis explained 47% of the variance. It revealed that performance expectancy, social influence, habit, perceived susceptibility, and perceived severity were positively associated with the intention to use a live chat on familial cancer risk. Effort expectancy, facilitating conditions, information insufficiency, and cancer diagnosis were not related to usage intentions.; CONCLUSIONS: A live chat seems promising for providing information on familial cancer risk. When promoting the service, the personal benefits should be addressed in particular. UTAUT2 is an effective theoretical framework for explaining live chat usage intentions and does not need to be extended in the context of familial cancer risk. ©Paula Memenga, Eva Baumann, Hanna Luetke Lanfer, Doreen Reifegerste, Julia Geulen, Winja Weber, Andrea Hahne, Anne Muller, Susanne Weg-Remers. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 28.08.2023

Digital clinical empathy in a live chat: multiple findings from a formative qualitative study and usability tests.

Lütke Lanfer H, Reifegerste D, Weber W, et al. Digital clinical empathy in a live chat: multiple findings from a formative qualitative study and usability tests. BMC Health Services Research. 2024;24(1): 314.BACKGROUND: Clinical empathy is considered a crucial element in patient-centered care. The advent of digital technology in healthcare has introduced new dynamics to empathy which needs to be explored in the context of the technology, particularly within the context of written live chats. Given the growing prevalence of written live chats, this study aimed to explore and evaluate techniques of digital clinical empathy within a familial cancer-focused live chat, focusing on how health professionals can (a) understand, (b) communicate, and (c) act upon users' perspectives and emotional states.; METHODS: The study utilized a qualitative approach in two research phases. It examined the expected and implemented techniques and effectiveness of digital clinical empathy in a live chat service, involving semi-structured interviews with health professionals (n=9), focus group discussions with potential users (n=42), and two rounds of usability tests between health professionals (n=9) and users (n=18). Data were examined using qualitative content analysis.; RESULTS: Expected techniques of digital clinical empathy, as articulated by both users and health professionals, involve reciprocal engagement, timely responses, genuine authenticity, and a balance between professionalism and informality, all while going beyond immediate queries to facilitate informed decision-making. Usability tests confirm these complexities and introduce new challenges, such as balancing timely, authentic responses with effective, personalized information management and carefully framed referrals.; CONCLUSIONS: The study reveals that the digital realm adds layers of complexity to the practice of clinical empathy. It underscores the importance of ongoing adaptation and suggests that future developments could benefit from a hybrid model that integrates the strengths of both AI and human health professionals to meet evolving user needs and maintain high-quality, empathetic healthcare interactions. © 2024. The Author(s)

Understanding Trust Determinants in a Live Chat Service on Familial Cancer: Qualitative Triangulation Study With Focus Groups and Interviews in Germany

BackgroundIn dealing with familial cancer risk, seeking web-based health information can be a coping strategy for different stakeholder groups (ie, patients, relatives, and those suspecting an elevated familial cancer risk). In the vast digital landscape marked by a varied quality of web-based information and evolving technologies, trust emerges as a pivotal factor, guiding the process of health information seeking and interacting with digital health services. This trust formation in health information can be conceptualized as context dependent and multidimensional, involving 3 key dimensions: information seeker (trustor), information provider (trustee), and medium or platform (application). Owing to the rapid changes in the digital context, it is critical to understand how seekers form trust in new services, given the interplay among these different dimensions. An example of such a new service is a live chat operated by physicians for the general public with personalized cancer-related information and a focus on familial cancer risk. ObjectiveTo gain a comprehensive picture of trust formation in a cancer-related live chat service, this study investigates the 3 dimensions of trust—trustor, trustee, and application—and their respective relevant characteristics based on a model of trust in web-based health information. In addition, the study aims to compare these characteristics across the 3 different stakeholder groups, with the goal to enhance the service’s trustworthiness for each group. MethodsThis qualitative study triangulated the different perspectives of medical cancer advisers, advisers from cancer support groups, and members of the public in interviews and focus group discussions to explore the 3 dimensions of trust—trustor, trustee, and application—and their determinants for a new live chat service for familial cancer risk to be implemented at the German Cancer Information Service. ResultsThe results indicate that experience with familial cancer risk is the key trustor characteristic to using, and trusting information provided by, the live chat service. The live chat might also be particularly valuable for people from minority groups who have unmet needs from physician-patient interactions. Participants highlighted trustee characteristics such as ability, benevolence, integrity, and humanness (ie, not a chatbot) as pivotal in a trustworthy cancer live chat service. Application-related characteristics, including the reputation of the institution, user-centric design, modern technology, and visual appeal, were also deemed essential. Despite the different backgrounds and sociodemographics of the 3 stakeholder groups, many overlaps were found among the 3 trust dimensions and their respective characteristics. ConclusionsTrust in a live chat for cancer information is formed by different dimensions and characteristics of trust. This study underscores the importance of understanding trust formation in digital health services and suggests potential enhancements for effective, trustworthy interactions in live chat services (eg, by providing biographies of the human medical experts to differentiate them from artificial intelligence chatbots)

Digital clinical empathy in a live chat: multiple findings from a formative qualitative study and usability tests

Abstract Background Clinical empathy is considered a crucial element in patient-centered care. The advent of digital technology in healthcare has introduced new dynamics to empathy which needs to be explored in the context of the technology, particularly within the context of written live chats. Given the growing prevalence of written live chats, this study aimed to explore and evaluate techniques of digital clinical empathy within a familial cancer-focused live chat, focusing on how health professionals can (a) understand, (b) communicate, and (c) act upon users’ perspectives and emotional states. Methods The study utilized a qualitative approach in two research phases. It examined the expected and implemented techniques and effectiveness of digital clinical empathy in a live chat service, involving semi-structured interviews with health professionals (n = 9), focus group discussions with potential users (n = 42), and two rounds of usability tests between health professionals (n = 9) and users (n = 18). Data were examined using qualitative content analysis. Results Expected techniques of digital clinical empathy, as articulated by both users and health professionals, involve reciprocal engagement, timely responses, genuine authenticity, and a balance between professionalism and informality, all while going beyond immediate queries to facilitate informed decision-making. Usability tests confirm these complexities and introduce new challenges, such as balancing timely, authentic responses with effective, personalized information management and carefully framed referrals. Conclusions The study reveals that the digital realm adds layers of complexity to the practice of clinical empathy. It underscores the importance of ongoing adaptation and suggests that future developments could benefit from a hybrid model that integrates the strengths of both AI and human health professionals to meet evolving user needs and maintain high-quality, empathetic healthcare interactions

Übersättigt mit Corona-Informationen? Befunde aus der zweiten Befragungswelle des Projekts CoreCrisis

Reifegerste D, Rossmann C, Temmann L, et al. Übersättigt mit Corona-Informationen? Befunde aus der zweiten Befragungswelle des Projekts CoreCrisis. Universität Erfurt; 2023.In einer globalen Gesundheitskrise wie der aktuellen Coronavirus-Pandemie ist es für die Bevölkerung besonders wichtig, sich mit den notwendigen Informationen versorgen zu können. Die erste Befragungs- welle des Projekts CoreCrisis lieferte Ergebnisse dazu, über welche Kanäle bestimmte Bevölkerungs- gruppen während der Frühphase einer solchen Krise am besten erreicht werden können (Rossmann et al., 2020). Mittlerweile dauert der Ausnahmezustand schon länger an und es stellt sich die Frage, wie sich die Menschen in ihrem Informationsverhalten auf die Situation eingestellt haben. Informierte sich die Bevölkerung im April anders über das Coronavirus als in der frühen Phase der Corona-Krise im März? Haben sich Wissen, Risikowahrnehmung, emotionale Reaktionen und In- formationsbedürfnisse im Zeitverlauf verändert? Antworten auf diese Fragen geben die Ergebnisse der zweiten CoreCrisis-Befragungswelle. Hierfür wurden 1.080 deutsche Bundesbürgerinnen und -bürger, die bereits an der ersten Befragungswelle zwischen dem 23. und 31. März 2020 teilgenommen hatten, zwischen dem 15. und 21. April 2020 erneut online befragt. Aus den Befunden lassen sich Empfehlun- gen für die zentralen Kommunikatoren und die Politik ableiten, um die Bevölkerung weiterhin bestmög- lich über Verhaltensregeln, neue Erkenntnisse und gesetzliche Vorgaben im Kontext des Coronavirus informieren zu können

Increasing influenza and pneumococcal vaccine uptake in the elderly: study protocol for the multi-methods prospective intervention study Vaccination60+

Background: Influenza and pneumococcal vaccination can prevent disease and potentially life-threatening complications like sepsis. Elderly people have an increased risk of severe disease and therefore constitute a major target group for vaccination. To increase vaccination coverage, targeted interventions are needed that take theory-based specific determinants of vaccination behaviour into account. Moreover, message and campaign design should consider specific age-related characteristics (e.g., information processing, media use). The aim of this study is (i) to identify the specific informational and interventional needs of this risk group, (ii) to design and implement a targeted intervention aiming to decrease vaccine hesitancy, increase vaccine uptake and decrease the health and economic burden due to the respective diseases, and (iii) to measure the effect of this evidence-informed intervention on various levels. Methods: Prospective, multi-methods intervention study targeting individuals aged ≥60 years in a model region in Germany (federal state of Thuringia, 500,000 inhabitants ≥60 years old). The development of the intervention follows theory-based and evidence-informed principles: Data from a cross-sectional representative study provide insights into specific determinants of the target group’s vaccination behaviour. Additionally, media use is analysed to identify adequate communication channels for specific subgroups. In pilot studies, the intervention materials are adapted to the specific cognitive requirements of the target group. For development and implementation of the intervention, an interdisciplinary and trans-sectoral approach is used, including psychology, communication science, design, medical science, epidemiology and various public health players. The intervention will be implemented in autumn and winter 2017/18 and 2018/19 and adjusted in between. Evaluation of the intervention includes: awareness, use and recall of intervention materials, effects on changes in determinants of vaccination behaviour, self-reported vaccine uptake, and vaccination coverage in the intervention area (primary outcomes), as well as disease incidences (secondary outcomes) and the economic burden of influenza, pneumonia, invasive pneumococcal disease and sepsis for the healthcare system (tertiary outcomes). Discussion: The data will add to the body of evidence on the effectiveness of evidence-informed vaccination campaign development as well as on the clinical and economic effects of pneumococcal and influenza vaccination. The effect of the intervention will teach valuable lessons about the principles of campaign development and evaluation, and can motivate a subsequent nationwide intervention.Peer Reviewe