As the most important global news distributors, the big three international news agencies’ reports about COVID-19 vaccines have a great influence on people’s understanding of them. Based on the health belief model (HBM), we examined which constructs in the HBM were related to audiences’ Twitter engagement and the differences among the agencies. We content-analyzed 1162 COVID-19 vaccine-related tweets from three international news agencies’ Twitter accounts (@AFPespanol, @AP, @Reuters) from 2 December 2020 to 31 January 2021. The results showed that the most-used HBM construct was barriers, followed by benefits, susceptibility, cues to action, severity, and self-efficacy. About half of the tweets used a positive tone and nearly half of the tweets used a neutral tone, while only 3.1% of the tweets used a negative tone. Reuters used a significantly more negative tone, more neutral tone, and less positive tone than was expected. AFP used a significantly more positive tone and less neutral tone than was expected. The effectiveness of utilizing HBM constructs for vaccination promotion strongly depends on the audience context. The use of HBM constructs for vaccination was generally effective for Reuters but seems to have backfired for AFP.

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Background Electronic cigarettes (e-cigarettes) have become increasingly popular. China has accelerated its legislation on e-cigarettes in recent years by issuing two policies to regulate their use: the first on August 26, 2018, and the second on November 1, 2019. Social media provide an efficient platform to access information on the public opinion of e-cigarettes. Objective To gain insight into how policies have influenced the reaction of the Chinese public to e-cigarettes, this study aims to understand what the Chinese public say about e-cigarettes and how the focus of discussion might have changed in the context of policy implementation. Methods This study uses a combination of text mining and correspondence analysis to content analyze 1160 e-cigarette–related questions and their corresponding answers from Zhihu, China’s largest question-and-answer platform and one of the country’s most trustworthy social media sources. From January 1, 2017, to December 31, 2019, Python was used to text mine the most frequently used words and phrases in public e-cigarette discussions on Zhihu. The correspondence analysis was used to examine the similarities and differences between high-frequency words and phrases across 3 periods (ie, January 1, 2017, to August 27, 2018; August 28, 2018, to October 31, 2019; and November 1, 2019, to January 1, 2020). Results The results of the study showed that the consistent themes across time were comparisons with traditional cigarettes, health concerns, and how to choose e-cigarette products. The issuance of government policies on e-cigarettes led to a change in the focus of public discussion. The discussion of e-cigarettes in period 1 mainly focused on the use and experience of e-cigarettes. In period 2, the public’s attention was not only on the substances related to e-cigarettes but also on the smoking cessation functions of e-cigarettes. In period 3, the public shifted their attention to the e-cigarette industry and government policy on the banning of e-cigarette sales to minors. Conclusions Social media are an informative source, which can help policy makers and public health professionals understand the public’s concerns over and understanding of e-cigarettes. When there was little regulation, public discussion was greatly influenced by industry claims about e-cigarettes; however, once e-cigarette policies were issued, these policies, to a large extent, set the agenda for public discussion. In addition, media reporting of these policies might have greatly influenced the way e-cigarette policies were discussed. Therefore, monitoring e-cigarette discussions on social media and responding to them in a timely manner will both help improve the public’s e-cigarette literacy and facilitate the implementation of e-cigarette–related policies.

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BACKGROUND After the COVID-19 outbreak, the World Health Organization (WHO) aimed to prevent the spread of the virus by providing various guidance related to the pandemic. One question that remains to be answered is to what extent such health promotion work. However, did such a promotion effort work? OBJECTIVE In order to know which communication strategies work to promote health-related beliefs and actions on social networking sites, this study examined what messages about COVID-19 were presented on the WHO’s Facebook posts, and evaluated WHO’s health promotion strategies by examining the public sentiments stimulated by different health promotion constructs. METHODS This study conducted a content analysis of 673 Facebook posts of the WHO from January 1, 2020, to December 31, 2020. Each Facebook post was examined for one or more of the HBM constructs, susceptibility, severity, benefits, barriers, cues to action, and ways to increase self-efficacy. The Facebook engagement variables were downloaded from the Facebook website including the number of “hit”, “comment”, “share”, “like”, “love”, “wow”, “ha-ha”, “sad”, and “angry”. RESULTS Results showed that the most frequently used HBM construct was cues to action, followed by susceptibility, severity, self-efficacy, benefits, and barriers. All HBM constructs were related to Facebook engagement variables, except barriers. Self-efficacy and cues to actions stimulated controversial sentiments. Benefits only stimulated users’ negative 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. CONCLUSIONS Previous research has regarded online engagement as simply the effect of health promotion, thus neglecting the fact that some engagement could also be expressions of rejection and opposition. Our results showed that the use of some HBM constructs such as benefits could produce counterproductive results. Policymakers should be alert to this phenomenon when implementing health promotion strategies. CLINICALTRIAL N/A