Health Communication Frameworks Used in Interventions to Mitigate Online Vaccine Misinformation and Disinformation: A Critical Narrative Review Pubblico

Abstract

This thesis presents a critical evaluation of health communication frameworks employed to mitigate vaccine misinformation and disinformation, with a focus on their implementation across digital platforms. Using a narrative literature review approach, the study synthesizes findings from twenty-two peer-reviewed studies published between 2010 and 2023. It examines how core models—including the Health Belief Model, Social Cognitive Theory, and the Elaboration Likelihood Model—have informed interventions aimed at reducing vaccine hesitancy driven by false or misleading information.

Three thematic categories emerged across existing literature: Action-Directed Communication, Engagement Communication, and Risk Communication Frameworks. These frameworks shaped the design and delivery of targeted interventions. Despite promising applications, several critical gaps remain. These include a lack of adaptability to platform-specific dynamics, overrepresentation of interventions in high-income country settings, absence of standardized metrics to assess effectiveness, and limited integration of psychological, cultural, and technological considerations.

The research underscores the influence of misinformation in eroding public trust in vaccines and highlights how tailored communication strategies can help counter this threat. Each of the evaluated frameworks offers unique mechanisms for influencing public perception and behavior—ranging from increasing awareness of disease risk, to leveraging peer networks and promoting critical evaluation of online content.

Effective interventions identified in the literature include the strategic use of social media, educational outreach, and community engagement through trusted health professionals. These approaches have proven successful in improving vaccine uptake and curbing the spread of misinformation by delivering credible content, fostering empathy, and aligning messages with cultural values and contexts.

This thesis contributes actionable insights for public health professionals and policymakers engaged in designing evidence-based communication strategies. It emphasizes the importance of inclusion, diversity, and equity in public health messaging and advocates for future research into the role of emerging technologies in combating digital misinformation.

Table of Contents

 APPROVAL SHEET...

ABSTRACT COVER PAGE ...

ABSTRACT....

COVER PAGE...

ACKNOWLEDGEMENT...i

TABLE OF CONTENTS...ii

LIST OF TABLES AND FIGURES.... iii

CHAPTER 1. 1

INTRODUCTION AND LITERATURE REVIEW... 1

1.1 Introduction... 1

1.1.1 Vaccination: A highly effective public health strategy for preventing infectious diseases... 1

1.1.2 Online Mis/Disinformation...2

1.1.3 Health Communication Frameworks... 3

1.1.4 Interventions to Mitigate Online Mis/Disinformation... 4

1.1.5 Evaluating the Effectiveness of Health Communication Interventions... 5

1.2 Public Health Problem... 6

1.3 Significance of the Study... 6

1.4 Problem Statement... 7

1.5 Scope of the Study... 7

1.6 Research Objectives... 8

CHAPTER 2...9

METHODS... 9

2.1 Research Design... 9

2.1.1 Overview of methodology... 9

2.1.2 Inclusion Criteria... 9

2.1.3 Exclusion criteria... 9

2.2 Search Strategy and Data Extraction... 10

2.2.1 Search Strategy... 10

2.2.2 Data Extraction and Synthesis Methods... 10

2.2.3 Data Extraction... 10

2.2.4 Data Synthesis...11

2.2.5 Data Analysis... 11

CHAPTER 3... 12

RESULTS... 12

3.1 Overview... 12

3.2 Objective 1: Health Communication Framework... 26

3.2.1 The Health Belief Model ...26

3.2.2 The Social Cognitive Theory... 26

3.3. Objective 2: Interventions Developed Based on Health Communication Framework... 28

3.3.1 Behavioral Change... 28

3.4 Objective 3: Efficacy of Interventions... 29

3.5 Thematic Organization... 30

3.5.1 Theme 1: Action-Directed Communication Frameworks... 30

3.5.2 Theme 2: Engagement Communication Frameworks... 32

3.5.3 Theme 3: Risk Communication Frameworks... 33

CHAPTER 4... 35

DISCUSSION... 35

4.1 Summary of Findings... 35

4.2     Similarities and Differences with Published Literature... 35

4.3 Implications... 37

4.3.1 To Public Health Practice... 37

4.3.2 To Public Health Policy... 37

4.4 Future Research... 38

4.5 Strengths and Limitations... 38

4.6 Conclusion...  40

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Parola chiave	communication intervention Vaccines online misinformation communication frameworks online disinformation health communication
Committee Chair / Thesis Advisor	Vasudevan, Lavanya, Emory University

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