Background As a result of demographic changes, the number of people aged 60 years and older has been increasing steadily. Therefore, older adults have become more important as a target group for health communication efforts. Various studies show that online health information sources have gained importance among younger adults, but we know little about the health-related internet use of senior citizens in general and in particular about the variables explaining their online health-related information–seeking behavior. Media use studies indicate that in addition to sociodemographic variables, lifestyle factors might play a role in this context. Objective The aim of this study was to examine older people’s health-related internet use. Our study focused on the explanatory potential of lifestyle types over and above sociodemographic variables to predict older adults’ internet use for health information. Methods A telephone survey was conducted with a random sample of German adults aged 60 years and older (n=701) that was quota-allocated by gender, age, educational status, and degree of urbanity of their place of residence. Results The results revealed that participants used the internet infrequently (mean 1.82 [SD 1.07]), and medical personnel (mean 2.89 [SD 1.11]), family and friends (mean 2.86 [SD 1.21]), and health brochures (mean 2.85 [SD 1.21]) were their main sources of health information. A hierarchical cluster analysis based on values, interests, and leisure time activities revealed three different lifestyle types for adults aged over 60 years: the Sociable Adventurer, the Average Family Person, and the Uninterested Inactive. After adding these types as second-step predictors in a hierarchical regression model with sociodemographic variables (step 1), the explained variance increased significantly (R2=.02, P=.001), indicating that the Average Family Person and the Sociable Adventurer use the internet more often for health information than the Uninterested Inactive, over and above their sociodemographic attributes. Conclusions Our findings indicate that the internet still plays only a minor role in the health information–seeking behavior of older German adults. Nevertheless, there are subgroups including younger, more active, down-to-earth and family-oriented males that may be reached with online health information. Our findings suggest that lifestyle types should be taken into account when predicting health-related internet use behavior.

BackgroundInfluenza 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.MethodsProspective, 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).DiscussionThe 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.Trial registration DRKS00012653. Registered 24.11.2017. Retrospectively registered.

The COVID-19 pandemic is challenging healthcare systems worldwide and is causing numerous deaths. Vaccination is an important tool to help us get back to normal; however, the majority of the public must be willing to get vaccinated to reach herd immunity. By considering postulates of message framing and socioemotional selectivity theory, this study investigated the effects of gain-loss framing on younger and older adults' reactance arousal, attitudes toward the coronavirus vaccination, vaccination intention, and recognition performance. In a 2 × 2 online experiment in October 2020, 281 participants received textual health information about future vaccination against COVID-19 with either gain-or loss-framed messages (Factor 1). Half of the participants were aged 18-30 years, and the other half were 60 years and above (quasi-experimental Factor 2). Among younger adults, we found an antagonistic pattern of effects: While loss framing positively influenced vaccination attitudes and led to stronger vaccination intentions, it simultaneously decreased recognition accuracy. In contrast, there was no framing effect on attitudes and intentions in older adults, which might be a consequence of the positivity effect. These findings can be interpreted as a first step to uncover the interaction of age and framing in the coronavirus pandemic. Public Significance StatementThis study highlights the importance of an age-related communication approach to promote vaccination against COVID-19. The findings suggest that younger and older adults react differently to gain and loss frames in the context of the coronavirus pandemic.

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Insbesondere bei Jugendlichen und jungen Erwachsenen wurde bereits 2020 eine zunehmende Pandemiemüdigkeit beobachtet, die sich in einer geringeren Motivation äußerte, empfohlene Maßnahmen zum Schutz vor COVID-19 einzuhalten. Eine theorie- und evidenzbasierte Kommunikationsstrategie ist daher unerlässlich, um die Schutzbereitschaft effektiv zu steigern. Entsprechend wurde zunächst ein theoretisches Modell zur Erklärung des Schutzverhaltens junger Menschen entwickelt und dieses in zwei aufeinander aufbauenden Befragungsstudien empirisch geprüft, um auf dieser Basis verhaltenswirksame Botschaftsinhalte und geeignete Kommunikationskanäle zu identifizieren. Der vorliegende Beitrag stellt zunächst die theoretische Basis vor, um anschließend die empirischen Befunde zu skizzieren und daraus Handlungsempfehlungen für eine Kommunikationsstrategie abzuleiten.