Challenges and recommendations for COVID-19 public health messaging: a Canada-wide qualitative study using virtual focus groups

Abstract

ObjectivesTo understand Canadian’s attitudes and current behaviours towards COVID-19 public health measures (PHM), vaccination and current public health messaging, to provide recommendations for a public health intervention.DesignTen focus groups were conducted with 2–7 participants/group in December 2020. Focus groups were transcribed verbatim and analysed using content and inductive thematic analysis. The capability opportunity motivation behaviour Model was used as our conceptual framework.SettingFocus groups were conducted virtually across Canada.ParticipantsParticipants were recruited from a pool of individuals who previously completed a Canada-wide survey conducted by our research team.Main outcome measureKey barriers and facilitators towards COVID-19 PHM and vaccination, and recommendations for public health messaging.ResultsSeveral themes were identified (1) participants’ desire to protect family and friends was the main facilitator for adhering to PHM, while the main barrier was inconsistent PHM messaging and (2) participants were optimistic that the vaccine offers a return to normal, however, worries of vaccine efficacy and effectiveness were the main concerns. Participants felt that current public health messaging is inconsistent, lacks transparency and suggested that messaging should include scientific data presented by a trustworthy source.ConclusionsWe suggest six public health messaging recommendations to increase adherence to PHM and vaccination (1) use an unbiased scientist as a spokesperson, (2) openly address any unknowns, (3) more is better when sharing data, (4) use personalised stories to reinforce PHM and vaccinations, (5) humanise the message by calling out contradictions and (6) focus on the data and keep politics out.

A survey of COVID-19 vaccine acceptance across 23 countries in 2022

“…Frequency, content and channels of dissemination are key factors in message transmission and receipt. Public health communicators should regularly test messages and the source (messenger) for optimal reach and uptake 59 and integrate vaccine literacy strategies using qualitative formative research, such as focus groups among target audiences 60 , to assess content on current (for example, first-dose and Article https://doi.org/10.1038/s41591-022-02185-4 Vaccine hesitancy for children among parents was defined as having reported 'no' to the question of whether children received at least one dose of a COVID-19 vaccine and also 'unsure/no opinion', 'somewhat disagree' or 'strongly disagree' to the question of whether children will take a COVID-19 vaccine when available to them. Parental vaccine hesitancy was defined as having reported 'no' to the question of whether parents received at least one dose of a COVID-19 vaccine and also 'unsure/no opinion', 'somewhat disagree' or 'strongly disagree' to the question of whether the parent will take a COVID-19 vaccine when available to them.…”

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“…This trend is noted by other studies in high-income countries (( 17 )). The literature indicates that mixed attitudes may stem from inconsistent information from official sources (( 21 – 24 )), becoming a risk to communication and patient disregard for medical care (( 25 )).…”

“…According to the literature, the prospect of a “return to normal” is strong motivation for vaccine uptake (( 4 , 21 )). Although FSMs generally doubted its efficacy, they mainly got vaccinated to obtain the vaccine passport and to protect themselves against serious illness, especially in the case of men.…”

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“…Nevertheless, it is noteworthy that focus group studies have been strongly emphasized as a good strategy to understand the views of different stakeholders as the findings can generate rich and fluid information about the problem under focus [24,26]. In reality, the focus group method has been widely used in public health [17,27,28] and higher education [29]. In particular, evaluators have commonly used focus group discussions to understand program effects.…”