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|Title:||Making Sense of Social Media for Public Health Decision-makers - The Case of Childhood Immunization in Ontario|
|Keywords:||vaccination, immunization, public health, health policy, social media, social network analysis|
|Abstract:||The successful elimination of vaccine-preventable diseases is contingent on high-vaccine coverage rates in targeted populations. The proliferation of vaccine misinformation on social media has led to vaccine hesitancy in the past two decades. A highly contextual phenomenon, areas with an increased prevalence of vaccine hesitancy and vaccine exemption have been shown to correlate with decreased immunization coverage and intermittent vaccine-preventable disease outbreaks worldwide. Although the Canadian government has recommended the use of social media to increase public confidence in vaccines, little documentation exists regarding the perceptions of advisors and decision-makers in policy and communications for immunization towards vaccine hesitancy on social media, and the use of social media to increase public confidence in vaccines in the context of Ontario, Canada’s largest province. This thesis employed 3 unique mixed-methods studies to explore the role of social media in addressing the problem of vaccine hesitancy facilitated through misinformation about childhood vaccines in Ontario. The first study is a social network analysis that incorporates sentiment analysis to demonstrate that pro-vaccine and anti-vaccine communities operate in siloes with little interaction with one another. Those interactions that do occur are most commonly facilitated by sentiment and geographic location, rather than profession or affiliation of the social media user. The second study is a mixed methods content analysis illustrating significant differences in user attributes (emotion, medium shared in tweets, direction of information-sharing, and use of Twitter functions) among pro-, neutral, and anti-vaccine Twitter users, suggesting different motivations underlying Twitter use. Qualitative inquiry of links and reasons for negative vaccine sentiment illustrate the proliferation of pseudo-experts occupying social media, as well as concerns about vaccine safety and mistrust towards the government. The third study complements the first two studies, and uses documents and in-depth interviews with 23 advisers and decisionmakers in policy and communications to illustrate that although vaccine hesitancy is of concern, the use of social media to increase public confidence in vaccines is met with resistance due to a myriad of barriers at all levels of immunization policy and program delivery in the Province of Ontario. Implications for policy and practice of this study include the recognition that a multi-pronged approach is needed to increase the public’s confidence in vaccines. Elements of this multi-pronged approach could include: i) commitments to investing in understanding social media’s use in informing immunization at all levels of governance and decision-making; ii) the active surveillance of public sentiment and the public’s concerns about vaccines on social media using network analysis and content analysis; and iii) the fostering of interdisciplinary collaboration to design interventions that facilitate connectivity between siloes. The implications for future research include the need for continued commitment to the design, implementation, and evaluation of public health interventions on social media in the Ontario context. This study points to the need to pay attention to the behavioral attributes and affordances of social media in order to develop policies, communicative strategies, and programmatic designs that comprehensively address public concerns towards vaccines and, in turn, promote increased confidence in them.|
|Appears in Collections:||Open Access Dissertations and Theses|
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