Faculty of Humanities and Art, Macau University of Science and Technology, Macau, China.
Disease AI Laboratory on Epidemic and Medical Big Data Instrument Applications, Faculty of Innovation Engineering, Macau University of Science and Technology, Macau SAR, China.
PLoS One. 2024 Nov 18;19(11):e0311825. doi: 10.1371/journal.pone.0311825. eCollection 2024.
Based on the Health Belief Model (HBM), this study examined what messages about COVID-19 were presented on the World Health Organization (WHO)'s Facebook posts, and evaluated WHO's health promotion strategies by examining the public engagement and sentiment stimulated by different health promotion constructs. One issue with previous studies on HBM and social networking sites is that many researchers considered positive "online engagements" as evidence of "effective health promotion". However, online engagement measures such as shares and comments cannot reflect the sentiment's valence. Another limitation in previous studies is that they often failed to differentiate between sentiments towards health measures and sentiments towards the disease. We utilized Facebook's emojis to explore the public's distinct sentiments towards the WHO's COVID-19-related health measures and sentiments towards COVID-19. We used content analysis to examine the all the COVID-19-related Facebook posts published by the WHO in 2020, the first year of the pandemic when the COVID-19 vaccines were not generally available to the public. In general, the use of HBM constructs was successful in capturing users' attention and generating engagement. However, regarding the effect of the use of HBM constructs on the beliefs in COVID-19-related health measures, the results were complex. The mentioning of the beliefs about a disease (perceived susceptibility and severity) tend to induce people's negative sentiments. The mentioning of ways to increase self-efficacy and cues to actions significantly reduced people's online engagements and sentiment (either positive or negative). Benefits only stimulated users' negative reactions while barriers could not stimulate any reactions. Video and text posts generally attracted more Facebook engagement than image and text posts, while text-only posts generally received the least Facebook engagement. We demonstrated that certain health promotion strategies can backfire and even induce negative reactions. Policymakers should be alert to this phenomenon when mentioning certain constructs during health promotions.
基于健康信念模型（HBM），本研究考察了世界卫生组织（WHO）在其 Facebook 帖子中发布的有关 COVID-19 的信息，并通过考察不同健康促进结构激发的公众参与度和情绪，评估了世卫组织的健康促进策略。HBM 和社交网络研究的一个问题是，许多研究人员将积极的“在线参与”视为“有效健康促进”的证据。然而，在线参与措施，如分享和评论，无法反映情绪的正值。以前研究的另一个局限性是，它们往往未能区分针对健康措施的情绪和针对疾病的情绪。我们利用 Facebook 的表情符号来探索公众对世卫组织与 COVID-19 相关的健康措施的不同情绪以及对 COVID-19 的情绪。我们使用内容分析法来研究世卫组织在 2020 年发布的所有与 COVID-19 相关的 Facebook 帖子，这是大流行的第一年，当时 COVID-19 疫苗尚未广泛提供给公众。总的来说，HBM 结构的使用成功地吸引了用户的注意力并引起了互动。然而，关于 HBM 结构的使用对 COVID-19 相关健康措施的信念的影响，结果是复杂的。提及对疾病的信念（感知易感性和严重性）往往会引起人们的负面情绪。提及增加自我效能感和行动线索的方法显著降低了人们的在线参与度和情绪（无论是积极还是消极）。益处只会引起用户的负面反应，而障碍则无法引起任何反应。视频和文字帖子通常比图片和文字帖子吸引更多的 Facebook 参与度，而纯文字帖子通常获得的 Facebook 参与度最少。我们证明，某些健康促进策略可能适得其反，甚至会引起负面反应。政策制定者在健康促进中提到某些结构时应该警惕这种现象。
