Objective This study aims to investigate factors influencing COVID-19 vaccination intention in the United States. Methods A cross-sectional survey was conducted with 800 respondents recruited from an online panel managed by a survey company. Path analysis was employed to examine the relationships between the study variables. Results First, perceived susceptibility to COVID-19 vaccine side effects was negatively associated with vaccination intention whereas perceived severity did not show any significant impact. Second, vaccine-related knowledge was not directly related to vaccination intention, but it had an indirect and positive effect on vaccination intention via decreasing perceived susceptibility. Third, doctor-patient communication strengthened the negative effect of vaccine knowledge on perceived susceptibility and severity. Conclusion The results of this study offer insights on how to increase people’s vaccination intention and reduce their psychological concerns when making COVID-19 vaccine-related decisions. Practice Implications Government agencies should actively promote the effectiveness and importance of vaccination, while addressing concerns about vaccine safety in the public; Health initiatives also need to enhance the level of knowledge about COVID-19 vaccines through various media channels; Doctors can start the conversations about COVID-19 vaccination with their patients at the point of care and/or via online communication platforms.

The Internet increasingly has been recognized as an important medium with respect to population health. However, little is known about the mechanisms that underlie the potential impact of health-related Internet use on health outcomes. Based on the three-stage model of health promotion using interactive media, this study empirically tested a moderated mediation pathway model. Results showed that the effect of Internet health information seeking on three health outcomes (general, emotional, and physical) was completely mediated by respondents' access to social support resources. In addition, users' online health information seeking experience positively moderated this mediation path. The findings have significant theoretical and practical implications for the design of Internet-based health promotion resources to improve health outcomes.

Social media have been growing rapidly during the past decade. However, it remains unclear whether social media make people more emotionally healthy or less. This study aims to explore the effect of Instagram use on individuals’ social anxiety. With a general basis of the three-stage model of interactive media use for health promotion, we conducted a cross-sectional online survey study ( N = 388) in the context of Singapore and empirically tested a mediation pathway linking Instagram use to social anxiety. The results indicated that Instagram use did not directly increase social anxiety. Instead, social comparison, a proximal outcome, and self-esteem, an intermediate outcome played mediating roles, supporting the complete mediation effects. This finding provides important theoretical and practical implications for the design of health campaigns and education in this digital era to enhance the positive effect of social media on health and emotional well-being.

Purpose: To investigate the trend of patient portal use in the general population and the barriers to adoption. Participants: We analyzed 3 iterations of the Health Information National Trends Survey (HINTS) collected in 2014, 2017, and 2018. Measures: Patient portal use, high-speed Internet access, data safety confidence, prior experience of online patient provider communication (OPPC), and demographic variables. Analysis: Logistic regression analyses were conducted separately for the 3 iterations of HINTS. Results: The use of patient portals increased from 25.6% in 2014 to 30.5% in 2017, and 31.4% in 2018. These users were more likely to be white female with higher levels of education or income. Meanwhile, high-speed Internet access, prior experience of OPPC, and data safety confidence were positive predictors of patient portal use in all 3 iterations. Conclusion: The use of patient portals in the general public remains low and a significant digital divide persists, presenting a major challenge on meaningful use of electronic health record. We call for more effective interventions to address these gaps. Such interventions should target people of low socioeconomic status and focus on improving eHealth literacy and patients’ confidence in data safety.

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