The proliferation of misinformation on social media platforms poses significant challenges to public health, political discourse, and social cohesion. This study investigates the efficacy of a World Health Organization (WHO) infodemic intervention in mitigating the spread of misinformation and explores the underlying neural mechanisms involved in information processing. A sample of 77 university students was randomly assigned to an experimental group, which was exposed to the WHO's infodemic intervention, or a control group, which received a campaign on healthy lifestyle habits. Participants viewed a series of manipulated and non-manipulated tweets before and after the intervention, rating their likelihood to share, verify, and perceive the truthfulness of the information. Electroencephalogram (EEG) data were collected throughout the experiment to assess neural complexity using Sample Entropy (SampEn) measures. Results revealed that the experimental group significantly reduced their intention to share information and perceived truthfulness of both manipulated and non-manipulated items post-intervention. The control group showed no significant changes. EEG analysis demonstrated higher SampEn scores in the frontal and temporal regions for the experimental group post-intervention, indicating increased neural complexity and more homogeneous activation patterns. These findings suggest that the WHO intervention effectively enhanced participants' critical evaluation of information, reflected in both behavioral and neurophysiological changes. This study contributes to the growing body of research on misinformation interventions by providing evidence for the effectiveness of passive, less demanding campaigns in fostering critical thinking and information discernment. Moreover, it offers novel insights into the neural correlates of information processing following such interventions, highlighting the potential of combining behavioral and neurophysiological measures in misinformation research. These findings have important implications for developing targeted strategies to combat misinformation, enhance digital literacy, and inform future public health and policy initiatives in the digital era.

The infodemic during the public health policy transformation in Chinese mainland is known; however, the contributions of medical practitioners have not been evaluated. This study aimed to estimate the role of medical practitioners during the COVID-19 infodemic in Chinese mainland and reveal content structure and spatiotemporal features.

Data from medical practitioner accounts with the highest influence were collected from Sina-Weibo. Original contents were collected from March 1st, 2022 to October 1st, 2023. Misinformation were identified based on cross-validated content analysis. Propagation index, spatiotemporal and network analysis were performed.

A total of 236,775 posts were crawled, with 28,218 posts from 432 accounts filtered through a keyword search and 5825 out of 28,218 (20.6 %) posts from 287 out of 432 (66.4 %) accounts identified as COVID-19-related content. 640 out of 5825 (11.0 %) posts from 112 out of 287 (39.0 %) accounts were identified as misinformation and classified into 5 main types and 6 subtypes. Differences between internal and external accounts were reflected in the distribution of misinformation types. Propagators from various professions had different tendencies in terms of type, and several misinformation repropagation modes were observed. Social network analysis revealed strong correlations among propagators.

To our knowledge, this is the first mixed-methods study to examine the characteristics of medical practitioners as propagators in the infodemic in Chinese mainland. Our research suggested that Chinese medical practitioners significantly contributed to the COVID-19 infodemic in social media. This could exacerbate post-pandemic societal distrust in the medical system, potentially having far-reaching public health implications.

Global concerns regarding effective response strategies to the COVID-19 pandemic arose amid the swift spread of the virus to low- and middle-income country (LMIC) settings. Although LMICs instituted several measures to mitigate spread of the virus in low resource settings, including task shifting certain demand and supply functions to community actors such as community health workers (CHWs), there remains a lack of synthesized evidence on these experiences and lessons. This scoping review sought to synthesize evidence regarding the roles and challenges faced by CHWs during the fight against COVID-19, along with strategies to address these challenges.

We systematically searched several major electronic databases including PubMed, HINARI, Cochrane Library (Reviews and Trials), Science Direct and Google Scholar for relevant literature. The search strategy was designed to capture literature published in LMICs on CHWs roles during COVID-19 period spanning 2019-2023. Two researchers were responsible for retrieving these studies, and critically reviewed them in accordance with Arksey and O'Malley scoping review approach. In total, 22 articles were included and analysed using Clarke and Braun thematic analysis in NVivo 12 Pro Software.

Community health workers (CHWs) played a vital role during the COVID-19 pandemic. They engaged in health promotion and education, conducted surveillance and contact tracing, supported quarantine efforts, and maintained essential primary health services. They also facilitated referrals, advocated for clients and communities, and contributed to vaccination planning and coordination, including tracking and follow-up. However, CHWs faced significant challenges, including a lack of supplies, inadequate infection prevention and control measures, and stigma from community members. Additionally, they encountered limited supportive policies, insufficient remuneration and incentives. To enhance CHWs' performance, regular training on preventive measures is essential. Utilizing digital technology, such as mobile health, can be beneficial. Establishing collaborative groups through messaging platforms and prioritizing access to COVID-19 vaccines are important steps. Additionally, delivering wellness programs and providing quality protective equipment for CHWs are crucial for their effectiveness.

The study found that CHWs are vital actors within the health system during global pandemics like COVID-19. This entails the need for increased support and investment to better integrate CHWs into health systems during such crises, which could ultimately contribute to sustaining the credibility of CHWs programs and foster more inclusive community health systems (CHSs).

This study examines demographic and attitudinal determinants of belief in COVID-19 conspiracy beliefs in Poland and their impact on psychological well-being, social functioning, and adherence to public health measures over one year. A cross-sectional study with a retrospective component was conducted one year after the pandemic outbreak (N = 1000). A COVID-19 conspiracy belief factor, extracted via PCA, served as the dependent variable in hierarchical regression models. Changes in P-score (psychological distress), S-score (social functioning), WHO-5 score (well-being), and adherence to public health guidance were analyzed using t-tests. Key predictors of conspiracy belief included lower education, younger age, higher religiosity, and distrust in experts. Conspiracy believers (CTB) exhibited significantly higher P-scores (greater psychological distress) compared to non-believers (N-CTB). While S-score (social functioning) and WHO-5 score (well-being) declined in both groups over time, differences between CTB and N-CTB were not significant. Stronger conspiracy beliefs were associated with lower adherence to public health guidelines from the pandemic's outset, with no significant improvement after one year. These findings confirm previous research linking conspiracy beliefs to reduced adherence to health measures and poorer psychological outcomes. However, they challenge assumptions that conspiracy beliefs necessarily impair well-being and social functioning over time. Strengthening institutional trust and addressing misinformation remain critical for improving public health compliance.

Developing optimal health communication strategies about COVID-19 and vaccines requires an understanding of the health literacy level of populations, trusted sources of information, and perceptions of COVID-19 messaging. We examined how health literacy is related to knowledge about COVID-19 among American Indian and Alaska Native (AI/AN) peoples.

We surveyed 788 AI/AN peoples at five Tribal health organizations between January and May 2021. We assessed health literacy using a 4-item health literacy index, and knowledge of COVID-19 in three domains: protection against contracting COVID-19; contracting COVID-19, and clinical manifestations of contraction. Questions also included rating trust of COVID-19 information sources and perceptions of messaging.

Participants had a high level of knowledge about COVID-19; however, health literacy was not significantly associated with any domain of COVID-19 knowledge. Participants perceived the most trusted source of COVID-19-related health information to be health professionals, followed by health clinics. Social media was the least trusted source of information. Tribal sources of information were rated on average higher quality than non-tribal sources.

AI/AN peoples had high levels of accurate knowledge about COVID-19 regardless of assessed health literacy. Information sources should include Tribal-led organizations and health professionals to increase uptake of COVID-19 messaging.

As we move beyond the COVID-19 pandemic, the risk of future infodemics remains significant, driven by emerging health crises and the increasing influence of artificial intelligence in the information ecosystem. During periods of apparent stability, proactive efforts to advance infodemiology are essential for enhancing preparedness and improving public health outcomes. This requires a thorough examination of the foundations of this evolving discipline, particularly in understanding how to accurately identify an infodemic at the appropriate time and scale, and how to distinguish it from other processes of viral information spread, both within and outside the realm of public health. In this paper, we integrate expertise from data science and public health to examine the key differences between information production during an infodemic and viral information spread. We explore both clear and subtle distinctions, including context and contingency (ie, the association of an infodemic and viral information spread with a health crisis); information dynamics in terms of volume, spread, and predictability; the role of misinformation and information voids; societal impact; and mitigation strategies. By analyzing these differences, we highlight challenges and open questions. These include whether an infodemic is solely associated with pandemics or whether it could arise from other health emergencies; if infodemics are limited to health-related issues or if they could emerge from crises initially unrelated to health (like climate events); and whether infodemics are exclusively global phenomena or if they can occur on national or local scales. Finally, we propose directions for future quantitative research to help the scientific community more robustly differentiate between these phenomena and develop tailored management strategies.

Children and adolescents extensively use the internet in their daily lives, often seeking information related to health and well-being. In modern society, the volume of health information available in digital environments is constantly increasing. This includes both reliable and misleading content, making it challenging to assess trustworthiness. Digital health literacy is essential for navigating the digital information ecosystem, protecting oneself from misinformation, and making informed health decisions.

This representative study aims to examine the digital health literacy of children and adolescents in Germany and its association with sociodemographic factors.

A cross-sectional study design with face-to-face interviews was utilized to collect data from 1448 children and adolescents aged 9-18 years in Germany between October and November 2022. Digital health literacy was assessed using an adapted and translated version of the Digital Health Literacy Instrument (DHLI), which comprises 7 subscales: operational skills, navigation skills, information searching, self-generated content, evaluating reliability, protecting privacy, and determining relevance. Bivariate and binary logistic regression analyses were conducted to examine associations between digital health literacy subscales and sociodemographic characteristics (sex, age, migration background, school type, and perceived family affluence).

The study found that 419 out of 1362 (30.76%) children and adolescents had a problematic level of digital health literacy, while 63 out of 1362 (4.63%) had an inadequate level. Overall, the least difficulties were observed in operational skills and determining relevance, whereas the greatest challenges were related to protecting privacy and navigation skills. Age was significantly associated with 6 of the 7 subscales (excluding protecting privacy), with younger children (9-11 years) facing a higher risk of limited skills (operational skills: odds ratio [OR] 5.42, P=.002; navigation skills: OR 4.76, P<.001; information searching: OR 4.68, P<.001; adding self-generated content: OR 7.03, P<.001; evaluating reliability: OR 3.82, P<.001; and determining relevance: OR 4.76.42, P<.001). Migration background was associated with fewer limited digital health literacy skills, while low perceived family affluence was associated with more limited skills. In the subscales of information searching, self-generated content, and evaluating information reliability, a lower risk of limited skills was observed among those with a 2-sided migration background (information searching: OR 0.62, P=.02; adding self-generated content: OR 0.30, P=.003; and evaluating reliability: OR 0.66, P=.03). By contrast, a higher risk was found among those with low perceived family affluence, including in the subscale of determining relevance (information searching: OR 2.18, P<.001; adding self-generated content: OR 1.77, P=.01; evaluating reliability: OR 1.67, P<.001; and determining relevance: OR 1.58, P<.001). Although school type was not associated with any dimension, sex was linked to operational skills, with females having an increased risk of limited skills (OR 1.58, P=.03).

The results highlight a strong need for interventions to improve digital health literacy among children and adolescents, particularly in protecting privacy, navigation skills, and evaluating the reliability of health information. Effective interventions should be tailored to address the varying needs associated with age, migration background, and family affluence.

Immigrants face barriers to accessing healthcare owing to language and cultural differences. Considering the eHealth literacy of immigrant mother is important, particularly as many rely on online resources for information on childcare. This observational cross-sectional study aimed to identify the factors influencing eHealth literacy among immigrant mothers with young children in South Korea. We hypothesized that factors influencing eHealth literacy include perceived ease of seeking, credibility, positive experiences, and subjective norms for online health information, as conceptualized by the Technology Acceptance Model, including cultural adaptation. The analysis results revealed that perceived ease of seeking ( β = .45), positive experiences ( β = .14), and subjective norms ( β = .15) significantly affected eHealth literacy. Additionally, integrated cultural adaptation ( β = .23) and the child's medical history ( β = .11) significantly influenced eHealth literacy. To enhance eHealth literacy related to parenting for immigrant mothers, educating them on search strategies for online health information and fostering positive user experiences are crucial. Furthermore, these interventions should adopt a family-focused approach, with integrated cultural adaptation proving more beneficial for effective settlement support of immigrant mothers.

Social media became a key communication channel for public health agencies during the COVID-19 pandemic, especially for reaching younger populations less engaged with traditional channels. However, official social media health communication often fails to appeal to young people. Improving public health agency use of social media for health communication is vital to ensure health messages reach this priority population effectively, especially during public health emergencies.

This study aimed to co-design a social media communication framework for health messaging to young people with consideration to emergency settings. It integrated the perspectives of young people and professional stakeholders, health communicators responsible for social media messaging of government health departments.

An iterative co-design process was conducted in partnership with youth co-researchers. The framework was co-designed over three workshops with young people (18-24 years) and professional stakeholders. Workshop data were analysed collaboratively and the framework was updated iteratively following each workshop. The final framework was approved by the youth co-researchers and a new group of professional stakeholders.

Twenty-one young people and four professional stakeholders participated in workshops. Three youth co-researchers and three external professional stakeholders approved the final framework. Five recommendations for communicating health messages to young people on social media were developed following two iterations: (1) involve young people, (2) pitch at right level, (3) capture attention fast, (4) use current social media marketing techniques and (5) engage more with the public. The main barrier in emergency contexts was time constraints, but the recommendations were considered feasible if embedded in business-as-usual processes prior to the emergency.

These findings provide public health agencies a guide for health communication to young people on social media. Co-designing the recommendations centres the needs and preferences of young people, while ensuring they are feasible for professional stakeholders. By incorporating a variety of messaging approaches and actively involving young people in content development, public health agencies can better reach and engage young people, including during public health emergencies.

Young people were involved in study recruitment, workshop facilitation, data analysis and manuscript preparation as co-researchers. Methods also included co-design with young people and stakeholders.

Concern over the low hepatitis immunization rates is growing. It is generally believed that misinformation and disinformation are the main barriers to the success of mass immunization campaigns. This study intends to investigate the matter of online misinformation and disinformation about hepatitis vaccination and its implications.

The researchers employed a cross-sectional research design vis-à-vis a web-based survey method to collect data. Data were collected from a nationally representative sample of 1931 internet users across Pakistan. Participation in the study was voluntary. Data collection continued for four months, from Mar 1, 2024, to Jun 30, 2024.

The "results" of structural equation modeling show that misinformation and disinformation substantially structure risk perception regarding hepatitis, which, in turn, impacts problem recognition, involvement recognition, and constraint recognition. Besides, the outcomes uncovered that the chain of problem identification impacts situational motivation, which drives risk communication behaviors. Also, these risk communication behaviors are closely linked to individuals' motivation to receive the hepatitis vaccine.

This research concludes that managing misinformation and disinformation via strategically designed, valid, and reliable digital interventions improves the public's active response regarding willingness to get vaccinated against hepatitis. This study contributes to increasing public acceptance of the hepatitis vaccine by utilizing reliable and valid digital interventions to achieve a more active public health response.

Systematic reviews provide the best quality evidence about the effectiveness of health treatments. However, systematic reviews and the important role they play in healthcare are not well understood beyond the walls of academia and healthcare. Systematic reviews can help the public make more informed health choices, based on the best available evidence. The People's Review aims to provide an opportunity to members of the public to plan and complete a full systematic review online in a supportive and engaging manner. It will be a learning-by-doing experience to support the public's understanding of what reviews are, how they are done, why they matter, and how they can be used to support everyday health decisions.

In The People's Review the public will conduct a full systematic review, deciding the review question, planning the review, working on the parts of the review, and deciding how to share the review findings, in a 'learning by doing' process. The review will be conducted online in eight stages using Cochrane Crowd, an existing citizen science platform. The team working behind-the-scenes of The People's Review will design, produce, and share learning material to support the public's understanding at each stage of the review.

Involving the public in a systematic review online will enable members of the public to understand and use systematic reviews in everyday health choices. It provides the public with a unique 'learning by doing' opportunity to get to grips with what systematic reviews are and how they are produced. This article describes how we plan to involve the public in The People's Review. It is not a protocol for the systematic review itself - this will be published separately once the project has commenced, and the public have decided the review question.

Misinformation about COVID-19 vaccines has hampered their uptake worldwide. In Ghana, a belief that COVID-19 vaccines affect fertility is prevalent and difficult to counter. UNICEF Ghana co-produced a context-driven, behavioral science-based audio drama ('A shot of love') that aimed to debunk this misinformation narrative. In a randomized controlled trial, 13,000 young adults who had previously interacted with UNICEF's Agoo platform were randomized to either control (audio about nutrition) or intervention (audio drama debunking the COVID-19 misinformation). We found that the intervention had a strong protective effect against belief in misinformation, both directly after listening to the audio drama (adjusted Odds Ratio (aOR) 0.45, 95% Confidence Interval (CI) 0.34-0.59) as well as at the one-month follow-up (aOR 0.66, 95% CI 0.49-0.91). Similarly, the intervention had a strong effect on perceived safety of the COVID-19 vaccines directly after listening to the audio drama (aOR 1.56, 95% CI 1.22-2.00) and at one-month follow-up (aOR 1.53, 95% CI 1.13-2.07). Overall, our behavioral science-based, context-driven audio drama was effective in reducing the strength of belief in COVID-19 vaccine misinformation and increasing the perceived safety of the vaccines in Ghana.

The infodemics can increase the burden of outbreaks and emergencies. Many of the studies documented the impact and emergence of the infodemic situation during epidemics or pandemics in recent years. There is limited evidence on the preparedness and readiness of health departments to effectively manage the infodemic situation.

This research provides a comprehensive assessment of the health department's capabilities in crisis emergency risk communication and infodemic management, identifying key best practices, challenges and bottlenecks. It contributes to the field by offering a framework and methodologies for evaluating these capacities, aiding in improving infectious diseases outbreak response public health emergency management.

Countries and health departments can benefit from these insights by assessing the level of preparedness and readiness in this field and to implement targeted interventions to enhance their preparedness and response capabilities to misinformation and disinformation.

The COVID-19 pandemic highlighted the importance of journalism, especially data journalism, in conveying accurate and understandable scientific information. Journalists helped to convert difficult scientific findings into understandable narratives, improving public understanding and trust. During the fifth session of the WHO Pandemic and Epidemic Intelligence Innovation Forum, data journalists Rukmini S. (India), Christian Endt (Germany), and Aghnia Adzkia (Indonesia) discussed their pandemic reporting experiences. The collaboration among media, public health agencies, and academia was critical in guaranteeing fast and accurate data transmission. During the session, they also discussed the obstacles journalists confront, such as overcoming data gaps and resolving public mistrust caused by misinformation or imprecise government messaging. In response, journalists' aim is to bridge the communication gap between scientists and the general people, ensuring that even complex and unclear scientific findings could be understood. Moving forward, the emphasis is on the ongoing collaboration between data journalists, scientists, decision-makers and the public to improve knowledge and science communication. Data journalism will continue to be important in future public health emergencies because it promotes transparency, makes data available, and encourages public engagement. Collaborative efforts, technical briefings, and training opportunities will improve data journalists' ability to effectively report scientific breakthroughs, making public health communication more responsive and impactful.

During the COVID-19 pandemic, migrants living in Norway navigated a complex "infodemic", which encompassed diverse health information sources from health authorities and media from both local and their home country. This study aimed to explore the experiences of Indian migrants in Norway related to their encounters with varied, and sometimes inaccurate and conflicting information between India and Norway amidst COVID-19 pandemic. Qualitative interviews were conducted with 12 Indian migrants and data was analyzed using thematic analysis. The analysis yielded five main themes: (1) Transnational sources of information, (2) Drivers for trusting information, (3) Transnational healthcare-seeking behavior, (4) Influences underlying decision-making, and (5) Emotional impact of conflicting information. Our findings highlight the complexities of information consumption and its effects on the cognitive-emotional processes of migrants, discussing the role of factors such as familiarity, emotional ties, and trust. Further, the study identified the need for culturally sensitive health communication interventions, the establishment of trust with migrant communities through accurate information dissemination, and the requirement of strategies to support the emotional well-being of migrants in situations when health information varies quickly and differ geographically. The implications of this research extend to the development of effective public health strategies for migrant communities during global health crises.

The COVID-19 pandemic affected mental health worldwide. The COSMO-Spain study analyses risk perceptions, behaviours, knowledge and other pandemic related variables, such as well-being. This work aimed to assess the evolution of self-reported well-being in Spain from May 2021 to September 2022 and its association with demographic and COVID-19 related factors.

An online, nationwide cross-sectional panel survey was applied in seven rounds with 1000+ participants each, with a total sample of 7266 participants, representative of the Spanish adult general population. The main variable was well-being, measured with the World Health Organization Well-Being Index (WHO-5) total score, an index with a total score from 0 to 100 (0 = worst well-being, 100 = best well-being). Other variables included in the survey were: sociodemographic data, concern about COVID-19, feelings of depression and fear, COVID-19-related worries, risk perception, self-efficacy, preventive behaviours, pandemic fatigue, health literacy, information search behaviours, and trust in several institutions. A multiple linear regression was run to analyse the associated factors with the WHO-5 total score.

The WHO-5 total score showed a significant increase from rounds 6 (May-June 2021) to 8 (September-October 2021). Women (standardized b coefficient (b) = -0.10), youth or people with lower socioeconomic status (worsened financial situation (b = -0.10) or unemployed/furloughs (b = -0.04)) reported lower well-being levels, whereas having a university-level education showed the opposite (b = 0.11). Feeling less depressed was associated with higher well-being (b = 0.31).

This study shows rising levels of well-being until a plateau was reached in October 2021. Vulnerable groups may be at higher risk of worsened mental health and should be addressed by policymakers. Further longitudinal studies should evaluate causality and evolution patterns of well-being throughout the COVID-19 pandemic.

This paper addresses the question of identifying and distinguishing risk amplification incidents and patterns in the news media. To meet this objective, our study incorporates a novel "floodlight" approach utilizing the Society for Risk Analysis Glossary in conjunction with topic modeling and time-series analysis, to investigate risk-focused stories within a corpus of 271,854 US news articles over the past two decades. We find that risk amplification in the US news media is concentrated around seven core risk news categories-business, domestic affairs, entertainment, environment, geopolitics, health, and technology-which also vary in the risk-related terms that they predominantly employ. We also identify 14 signal events that can be distinguished relative to general risk news within their categories. Across these events, the "War on Terror" and COVID-19 are seen to display uniquely dynamic media reporting patterns, including a systemic influence between risk news categories and the attenuation of other risk news. We discuss possible explanations for these findings along with their wider research and policy implications.

Microorganisms are fundamental to life on Earth, influencing biogeochemical processes, soil fertility, and the health of humans, animals and plants. Human activities have left a remarkable footprint on the environment, including global microbiomes. Enhancing awareness and improving education about microbiome functions can contribute to a sustainable economy and resilient systems. However, public understanding of microbiome science is hindered by misinformation and limited accessible educational resources. To address this, we developed the massive open online course (MOOC) 'Microbiome & Health', available on iMooX.at and YouTube. The course, structured into six units, covers microbiome concepts, methodologies, human and plant microbiomes, antibiotic resistance, and environmental impacts, aligning with the One Health concept and the Sustainable Development Goals of the United Nations. Initial results show that the MOOC provides the means to increase microbiology literacy, with 73.2% external participation and above-average completion rates. Integration as a mandatory component in university courses has improved student performance, halting declining grades and pass rates. This highlights the MOOC's potential to enhance public and academic understanding of microbiome science, fostering informed decisions for sustainable health and environmental stewardship as well as paving the way for new microbiome-based solutions in biotechnology.

A meta-analysis was conducted to quantify the overall effect of health misinformation exposure on shaping misbelief. Aggregation of results from 28 individual randomized controlled trial studies (n = 8752) reveals a positive but small average effect, d = 0.28. Moderation analyses suggest that adults who are younger and female tend to develop higher misbelief if exposed to health misinformation. Furthermore, media platform, message falsity, and misbelief measurements also contribute to the exposure effect. These findings offer nuanced but crucial insights into existing misinformation literature, and development of more effective strategies to mitigate the adverse impacts of health misinformation.

To describe and analyze a community participation process to develop recommendations for adequate communication of mental health risks among the Wayuú people of Colombia.

This qualitative study conducted focus groups in the Indigenous cities of Albania and Uribia, Colombia, from January to June 2024, to assess perspectives on mental health risk communication. Participants were adults (>18 years) residing in two municipalities in La Guajira (Uribia and Albania [the Indigenous capital of Colombia]) and included youth group leaders, Indigenous representatives, migrant population representatives, and representatives of official institutions in the region. Thematic analysis was used for data analysis.

In total, 42 participants (mean [SD] age, 20.1 years; 24 [57.1%] women and 18 [42.9%] men) participated in four focus groups (two in Albania and two in Uribia). Three main themes were identified in the thematic analysis: consequences of poor communication; community advice for social communication; and recommendations for public mental health in health communication. Based on the data analysis, recommendations for mental health risk communication were proposed for both municipalities and for the territory of La Guajira, Colombia.

The findings of this qualitative study highlight the need to improve mental health communication among the Indigenous community by leveraging their perspectives. The involvement of community leaders and the development of mental health communication strategies are needed.

Background/Objectives: The COVID-19 pandemic has had a profound impact on physical, mental, and social aspects of life worldwide. This study aimed to explore and compare differences in knowledge, awareness, behavior, and the psychological impact of the pandemic among students of biomedical faculties at the University of Zagreb. Methods: A cross-sectional study was conducted between 27 November 2020 and 19 January 2021 involving 518 students from the School of Dental Medicine, School of Medicine, Faculty of Pharmacy and Biochemistry, and Faculty of Veterinary Medicine. An anonymous online questionnaire was distributed, assessing participants' knowledge about SARS-CoV-2, information sources, attitudes, and psychological responses. Data were analyzed using descriptive statistics and appropriate statistical tests. Results: The median knowledge score was 61.54%, with senior and female students demonstrating significantly more knowledge (p < 0.001 and p = 0.044, respectively). Students who consulted the scientific literature and official websites had higher knowledge levels (p < 0.001). Most participants used media and social networks for pandemic information, while scientific sources were underutilized. Psychological impacts were evident, with 46.3% expressing fear about the future and 25% reporting anxiety if they were to be infected. Additionally, those who engaged with the scientific literature were more likely to accept vaccination and showed lower levels of COVID-19 stigma. A majority (64.5%) believed that the media exaggerated the pandemic's risks. Conclusions: Biomedical students demonstrated moderate knowledge about COVID-19, with a clear link between scientific literacy and more informed, less stigmatizing attitudes. This study underscores the importance of reliable information sources in shaping public health awareness and highlights the need for further education on COVID-19 symptoms and preventive measures.

This research aimed to comprehensively explore the impact of diverse challenges encountered by older adults on the development of post-traumatic stress disorder (PTSD). It delved into how these effects vary depending on individuals' levels of trust in authority and medical professionals, providing a nuanced understanding of the interplay between external challenges, personal trust, and mental health outcomes in the older population.

The COVID-19 pandemic has imposed significant hardships, particularly on the ageing population, with potential psychological repercussions such as PTSD. Notably, there is a dearth of research exploring this association within the context of Chinese older adults, a group that may experience unique impacts due to cultural differences in the face of global crises.

Data were collected from a representative sample of 1,211 participants aged 60 years and above in Shenzhen. Logistic and hierarchical linear regression methods were utilized to investigate the relationship between the challenges posed by COVID-19, public trust, and the manifestation of PTSD symptoms.

Higher levels of challenges related to 'supplies, services access and safety', 'abuse and conflicts', and 'anger and fear' were associated with PTSD. Furthermore, a lower level of challenges related to 'disease management and information' was associated with PTSD. Trust in authority or medical professionals was the moderator between the challenges brought about by COVID-19 and PTSD, which helped to lower the impact of challenges. Despite the challenges brought by COVID-19 to people, nurturing a stronger sense of trust in authority and medical professionals would ease older adults' psychological stress and concerns.

We study the spreading dynamics of content on networks. To do this, we use a model in which content spreads through a bounded-confidence mechanism. In a bounded-confidence model (BCM) of opinion dynamics, the agents of a network have continuous-valued opinions, which they adjust when they interact with agents whose opinions are sufficiently close to theirs. Our content-spreading model, which one can also interpret as an independent-cascade model, introduces a twist into BCMs by using bounded confidence for the content spread itself. We define an analog of the basic reproduction number from disease dynamics that we call an opinion reproduction number. A critical value of the opinion reproduction number indicates whether or not there is an "infodemic" (i.e., a large content-spreading cascade) of content that reflects a particular opinion. By determining this critical value, one can determine whether or not an opinion dies off or propagates widely as a cascade in a population of agents. Using configuration-model networks, we quantify the size and shape of content dissemination by calculating a variety of summary statistics, and we illustrate how network structure and spreading-model parameters affect these statistics. We find that content spreads most widely when agents have a large expected mean degree or a large receptiveness to content. When the spreading process slightly exceeds the infodemic threshold, there can be longer dissemination trees than for larger expected mean degrees or receptiveness (which both promote content sharing and hence help push content spread past the infodemic threshold), even though the total number of content shares is smaller.

Health literacy is becoming increasingly important in the field of public health as it contributes to individuals' social empowerment. During the coronavirus disease 2019 (COVID-19) pandemic, preventive measures (mask usage, physical distancing, hand washing) and vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shaped the degree of infection of the population, and their acceptance was associated with a multitude of factors, health literacy included. The aim of this scoping review is to explore the impact of all health literacy dimensions (namely, understanding, access, evaluation and application of health information) on accepting preventive measures and vaccination against SARS-CoV-2 among adult European citizens.

A literature search on three different databases was conducted from July 2022 to December 2022.

A total of 154 articles were initially identified, which were rigorously assessed by two reviewers. Ten studies that met the inclusion criteria were analyzed. The results showed that health literacy played an important role in accepting preventive measures and vaccination as well as in rating health information related to the coronavirus.

Health literacy is a positive predictor of coronavirus prophylaxis and could be incorporated into public health policies to appropriately control future health crises. [HLRP: Health Literacy Research and Practice. 2025;9(1):e46-e55.].

The COVID-19 pandemic exposed critical gaps in health system preparedness. This study, guided by a critical ecological model, examines the experiences of primary health and community services in Aotearoa New Zealand during the pandemic, focusing on their response to older people and their unpaid caregivers. The study aims to identify effective strategies for health system resilience. It addresses the question, what can we learn from the experiences of organisations supporting older people and caregivers during COVID-19, to prepare for other similar (emergency health) situations?

A multidisciplinary research team conducted cross-sectional qualitative research through semi-structured telephone interviews with service providers (SPs) delivering primary or community home-based services to older people and caregivers across Aotearoa New Zealand. SPs included national organisations, Māori, Pacific, or rural providers and dementia services. Data were collected between July and October 2020. Notes were taken during interviews using a Rapid Appraisal Procedure grid, which were later revised and validated by participants. Data were analysed using a hybrid deductive-inductive thematic analysis, following COREQ guidelines.

Twenty staff (Chief Executive Officers and representatives) from national organisations (N = 4), Māori (N = 3), Pacific (N = 5), rural (N = 4), and regional dementia (N = 4) SPs were interviewed. SPs demonstrated resilience through collaboration, adapting delivery models, and upskilling staff. Key challenges involved inconsistent identification of vulnerable clients, limited access to aged residential care, and barriers relating to digital access which disproportionately affected older adults and staff, and clients in rural areas. Workforce shortages, and unclear public policy concerning travel across regions further complicated service delivery, highlighting the interaction between policy, community, interpersonal, and individual factors.

Aotearoa New Zealand managed COVID-19 effectively, but the pandemic exposed areas for improvement in health system resilience. The government demonstrated absorptive resilience through swift actions, including lockdowns and clear communication, while SPs exhibited adaptive resilience by modifying service protocols. Knowledge gained from this study can contribute to transformative resilience. Long-term strategic changes are necessary to improve emergency planning, such as developing a unified framework to inform a 'Priority List', enhancing workforce capacity, and addressing digital exclusion. These steps can strengthen health system robustness and preparedness for future crises.

The COVID-19 pandemic marked a unique period characterised by an extraordinary global virus spread. The collective effort to halt the transmission of the virus led to various public health initiatives, including a variety of COVID-19 vaccine trials. Many of these trials used adaptive methods to address the pandemic's challenges, such as the need for rapid recruitment. These adaptive methods allow for modifications to the trial procedures without undermining the trial's integrity, making the research process more flexible and efficient. However, recruiting participants for vaccine trials remains a considerable challenge. The aim of this qualitative evidence synthesis (QES) is to explore the factors that influence a person's decision to participate in a COVID-19 vaccine trial. Lessons learned from this could help shape future trials' design and conduct, particularly those conducted within a pandemic.

We conducted a systematic search for qualitative studies and mixed methods studies with a qualitative component in the WHO COVID-19 Research Database, MEDLINE, CINAHL, PsycINFO, Epistemomikos, Online Resource for Research in Clinical Trials (ORCCA), and the Cochrane COVID-19 Study Register. We used the best-fit framework synthesis approach and the Social Ecological Model as an a priori framework. We used the GRADE-CERQual approach to assess our confidence in the review findings.

Five studies involving 539 participants were included. One of these studies included participants in a COVID-19 vaccine trial. In three of the studies, participants were asked hypothetically about their attitudes. Another study included people who had either not responded to or declined an invitation to participate in a COVID-19 vaccine trial. We developed six themes outlining the factors that influence a person's decision to participate in a COVID-19 vaccine trial: (1) personal gains, (2) perceived risk, (3) influence of family and community, (4) contributing for others, (5) institutional trust and mistrust, and (6) accessibility of the trial.

This review sheds light on how people perceive the potential personal, family, and community advantages of trial participation and how these perceptions may be weighed against concerns about vaccine safety. The findings also point toward specific aspects of trial methodology to consider when designing COVID-19 vaccine trials.

Toxicity on social media, encompassing behaviors such as harassment, bullying, hate speech, and the dissemination of misinformation, has become a pressing social concern in the digital age. Its prevalence intensifies during periods of social crises and unrest, eroding a sense of safety and community. Such toxic environments can adversely impact the mental well-being of those exposed and further deepen societal divisions and polarization. The 2022 mpox outbreak, initially called "monkeypox" but later renamed to reduce stigma and address societal concerns, provides a relevant context for this issue.

In this study, we conducted a comprehensive analysis of the toxic online discourse surrounding the 2022 mpox outbreak. We aimed to dissect its origins, characterize its nature and content, trace its dissemination patterns, and assess its broader societal implications, with the goal of providing insights that can inform strategies to mitigate such toxicity in future crises.

We collected >1.6 million unique tweets and analyzed them with 5 dimensions: context, extent, content, speaker, and intent. Using topic modeling based on bidirectional encoder representations from transformers and social network community clustering, we delineated the toxic dynamics on Twitter.

By categorizing topics, we identified 5 high-level categories in the toxic online discourse on Twitter, including disease (20,281/43,521, 46.6%), health policy and health care (8400/43,521, 19.3%), homophobia (10,402/43,521, 23.9%), politics (2611/43,521, 6%), and racism (1784/43,521, 4.1%). Across these categories, users displayed negativity or controversial views on the mpox outbreak, highlighting the escalating political tensions and the weaponization of stigma during this infodemic. Through the toxicity diffusion networks of mentions (17,437 vertices with 3628 clusters), retweets (59,749 vertices with 3015 clusters), and the top users with the highest in-degree centrality, we found that retweets of toxic content were widespread, while influential users rarely engaged with or countered this toxicity through retweets.

Our study introduces a comprehensive workflow that combines topical and network analyses to decode emerging social issues during crises. By tracking topical dynamics, we can track the changing popularity of toxic content on the internet, providing a better understanding of societal challenges. Network dynamics highlight key social media influencers and their intentions, suggesting that engaging with these central figures in toxic discourse can improve crisis communication and guide policy making.

The media have played an important part in presenting arguments for and against vaccination. The potential for the media to influence public attitudes to vaccines is becoming increasingly crucial to address.

To understand the differing roles and responsibilities in the communication of vaccine trials we draw insight from a retrospective study of 349 survey responses and 102 semi-structured interviews conducted in 2020 with participants in the United Kingdom's first-in-human clinical trial of the Oxford-AstraZeneca COVID-19 vaccine.

We found that trial participants had mixed views as to whether their participation conferred responsibility to communicate more widely about their trial experiences. Some participants perceived themselves to have an altruistic obligation to communicate to the media about the trial, and others felt that those who did share their participation had 'attention-seeking' motives. When participants did speak out they preferred to do so anonymously. Frustration was also reported with sensationalised and false media stories. Social media was viewed as a means to accelerate misinformation or as a force for recruitment and public education about trials. Participants were pleased to see trial investigators and trial team playing prominent roles in the media and this instilled confidence in the vaccine and the trial. We discuss these evolving roles and responsibilities for trial communication, concentrating on the views of participants about experiences, opportunities, and risks.

We argue that the pandemic has demonstrated the need for clinical trials to be made more transparent as a scientific practice that requires better public understanding and engagement. For high-profile vaccine trials we recommend; (1) explicit and comprehensive guidance aimed at all participants for interactions with the media; (2) prioritising having open and effectively expressed accounts of trial composition, processes, and participation; (3) offering support and a direct communication channel for journalists to report trials by utilising internal press officers to engage with journalists.

During the COVID-19 pandemic, many advocacy groups and individuals criticized governments on social media for doing either too much or too little to mitigate the pandemic. In this article, we review advocacy for COVID-19 elimination or "zero-covid" on the social media platform X (Twitter). We present a thematic analysis of tweets by 20 influential co-signatories of the World Health Network letter on ten themes, covering six topics of science and mitigation (zero-covid, epidemiological data on variants, long-term post-acute sequelae (Long COVID), vaccines, schools and children, views on monkeypox/Mpox) and four advocacy methods (personal advice and promoting remedies, use of anecdotes, criticism of other scientists, and of authorities). The advocacy, although timely and informative, often appealed to emotions and values using anecdotes and strong criticism of authorities and other scientists. Many tweets received hundreds or thousands of likes. Risks were emphasized about children's vulnerability, Long COVID, variant severity, and Mpox, and via comparisons with human immunodeficiency viruses (HIV). Far-reaching policies and promotion of remedies were advocated without systematic evidence review, or sometimes, core field expertise. We identified potential conflicts of interest connected to private companies. Our study documents a need for public health debates to be less polarizing and judgmental, and more factual. In order to protect public trust in science during a crisis, we suggest the development of mechanisms to ensure ethical guidelines for engagement in "science-based" advocacy, and consideration of cost-benefit analysis of recommendations for public health decision-making.

With the COVID-19 pandemic, social isolation, and information search have increased dramatically. This increased search for information about the Coronavirus, called infodemic, was greatly affected by fake news and information without scientific evidence. This article aimed to assess the infodemic amid the COVID-19 pandemic and its association with sociodemographic and pandemic-related variables, as well as describe the main sources from which people obtained information about COVID-19.

A cross-sectional population-based study was performed in Criciúma, Brazil. All individuals aged 18 years or older, residing in the 607 households systematically selected, were invited to answer the questionnaire. Infodemic and sources to seek information about COVID-19 were evaluated, as well as sociodemographic and pandemic-related variables. Adjusted Poisson regression with robust variance was used to evaluate associations.

A total of 863 individuals participated in the study. The prevalence of infodemic was 22.1%, and television was the main source of information (58.9%). Three groups presented a higher prevalence of infodemic: older adults (PR: 1.65), individuals with low income (PR: 2.97), and those who had had contact with someone infected (PR: 2.20).

The findings reflect how some groups are more exposed to infodemic, and underline the responsibility and importance of intersectoral actions for dissemination of information about COVID-19.

The rapid expansion of the Internet and social media has intensified the spread of health misinformation, posing significant risks, especially for older adults. This meta-analysis synthesizes evidence on the prevalence and interventions of health misinformation among older adults. Our findings reveal a high prevalence rate of 47% (95% CI [33%, 60%]), surpassing recent estimates. Offline research settings have a higher prevalence of health misinformation. Despite methodological variances, the prevalence remains consistent across different measures and development levels. Interventions show significant effectiveness (Hedges' g = 0.76, 95% CI [0.25, 1.26]), with graphic-based approaches outperforming video-based ones. These results underscore the urgent need for tailored, large-scale interventions to mitigate the adverse impacts of health misinformation on older adults. Further research should focus on refining intervention strategies and extending studies to underrepresented regions and populations.

Mpox is a zoonotic viral disease that presents significant public health challenges. Despite the pivotal role of healthcare workers, research on their knowledge and attitudes towards mpox is limited. This study aimed to assess healthcare workers' knowledge, awareness and attitude regarding mpox as well as associated factors at Rivers State University Teaching Hospital in Nigeria. A descriptive cross-sectional study design was employed, utilizing a 34-item semi-structured questionnaire. Knowledge levels were categorized as good (> 70% score), fair (50-69%), or poor (< 50%), while attitudes were classified as positive (> 70% score), moderate (50-69%), or negative (< 50%). Statistical analyses included independent sample T-test, One-way Analysis of Variance, and Chi-square tests. Among a total of 227 healthcare professionals, majority were females (59%) and singles (54.2%). Over 79% correctly identified mpox as a viral infection, while 59.9% recognized its potential transmission through a monkey bite. Overall, 22.5% demonstrated good knowledge. Majority (61.7%) acknowledged the potential of mpox as a worldwide pandemic, with 89% agreeing it could strain affected countries' healthcare systems. Healthcare workers exhibited moderate to positive attitudes towards mpox. Gender (Males, (p = 0.003), age (> 40 years (p = 0.008), years of experience (6-10 years; (p < 0.001), professional qualification (physicians, (p = 0.002), and previous mpox training (p < 0.001) significantly influenced knowledge levels, but no significant associations were found between demographic variables and attitudes. The study revealed a high level of awareness but low to fair knowledge among most participants. Healthcare professionals also demonstrated moderate to positive attitudes towards mpox. Factors such as gender, age, years of experience, professional qualification, and previous training on mpox influenced knowledge levels, but did not influence attitude in the study participants highlighting the importance of targeted educational interventions.

During the COVID-19 pandemic, health literacy was found to be an asset to manage health-related information. The HLS-COVID-Q22 has been developed to measure COVID-19 health literacy. External validation needs to be assessed in different populations to verify the questionnaire's functioning. The present study aimed to evaluate the psychometric properties of the HLS-COVID-Q22 in a sample of German school principals.

The sample consisted of 2187 German school principals who completed the HLS-COVID-Q22 online from April to March 2021. The data was analyzed using Rasch analysis, applying the Partial Credit Model for polytomous data. Dimensionality, item fit statistics and rating scale functioning was tested. Values for item difficulty and person ability as well as reliability indices were computed.

Unidimensionality could be confirmed. The rating scale categories worked as intended, participants used every rating step category. Generally, item fit was verified. One item showed potential misfit but could remain in the questionnaire as excluding the item did not reduce reliability. A person separation index of 3.41 and person reliability of 0.92 showed excellent differentiation between COVID-19 health literacy levels. Furthermore, the values for item separation of 20.08 and item reliability of 1.0 indicate good construct validity.

The German version of the HLS-COVID-Q22 appears to be a reliable measurement tool for the target population. Evidence for construct, statistical and fit validity was collected. Future studies need to test additional types of validity like convergent and divergent validity to further evaluate the questionnaire. Moreover, the psychometric properties of the translated versions of the HLS-COVID-Q22 should be compared using Rasch analysis.

"Forbidden knowledge" claims are central to conspiracy theories, yet they have received little systematic study. Forbidden knowledge claims imply that information is censored or suppressed. Theoretically, forbidden knowledge could be alluring or alarming, depending on alignment with recipients' political worldviews. In three studies (N = 2363, two preregistered), we examined censorship claims about (conservative-aligned) controversial COVID-19 topics. In Studies 1a and 2 participants read COVID-19 claims framed as censored or not. Conservatives reported more attraction to and belief in the claims, regardless of censorship condition, while liberals showed decreased interest and belief when information was presented as censored. Study 1b revealed divergent interpretations of suppression motives: liberals assumed censored information was harmful or false, whereas conservatives deemed it valuable and true. In Study 2, conservatives made more critical thinking errors in a vaccine risk reasoning task when information was framed as censored. Findings reveal the polarizing effects of forbidden knowledge frames.

This study analyzed online public discourse on Twitter (later rebranded as X) during the COVID-19 pandemic to understand key factors associated with vaccine hesitancy by employing deep-learning techniques. Text classification analysis reveals a significant association between attitudes toward vaccination and the unique socio-economic characteristics of US states, such as education, race, income or voting behavior. However, our results indicate that attributing vaccine hesitancy solely to a single social factor is not appropriate. Furthermore, the topic modeling of online discourse identifies two distinct sets of justifications for vaccine hesitancy. The first set pertains to political concerns, including constitutional rights and conspiracy theories. The second pertains to medical concerns about vaccine safety and efficacy. However, vaccine-hesitant social media users pragmatically use broad categories of justification for their beliefs. This behavior may suggest that vaccine hesitancy is influenced by political beliefs, unconscious emotions, and gut-level instinct. Our findings have further implications for the critical role of trust in public institutions in shaping attitudes toward vaccination and the need for tailored communication strategies to restore faith in marginalized communities.

The decision-making (DM) process in public administration is the subject of research from different perspectives and disciplines. Evidence-based policies, such as health technology assessment (HTA), are not the only support on which public policies are designed. During the COVID-19 pandemic WHO, national and subnational institutions developed HTA reports to guide DM. Despite this, inadequate variability was observed in the health technologies recommended and reimbursed by different provincial Health Ministries in a federally organized developing country like Argentina. The processes and results of DM on health technologies for COVID-19 in Health Ministries of Argentina were inquired.

A retrospective research design was developed, with triangulation of quantitative and qualitative methods. We retrieved information for the years 2020-2021 through document review of official webpages, surveys, and interviews with decision-makers of the 25 Argentinian Ministries of Health. We analyzed the recommendations and reimbursement policies of seven health technologies.

In contradiction with WHO's policies, ivermectine, inhaled ibuprofen, convalescent plasma and equine serum were widely recommended by most of Argentina's health ministries outside a clinical trial context, with risks for patients and a huge opportunity cost.

Despite an important HTA institutional capacity, the impact of HTA organizations and their technical reports was limited. Health Ministries with institutionalized HTA units had more adherence to WHO recommendations, but the influence of different technical and political criteria was identified. Power relations within and outside the administration, the pharmaceutical industry and academics, the media, social pressure, the judicial and legislative powers, and the political context strongly influenced DM.

The coronavirus disease 2019 (COVID-19) pandemic emphasized the importance of vaccinations for the prevention of life-threatening diseases and for avoiding the overburdening of the healthcare system. Despite the clear advantage of vaccinations, increasing vaccine hesitancy has been observed worldwide, especially among young people who are potential future parents. Vaccine hesitancy describes the delayed or lack of willingness to utilize recommended vaccinations and represents a substantial challenge for public health. This article analyzes the causes of vaccine hesitancy in the postpandemic period and discusses factors that could make communication successful. The role of artificial intelligence and structured evidence-based discussion techniques, such as the empathetic refutation interview, are emphasized. The aim is to provide practice-oriented recommendations to be able to provide physicians with tools that can help in the education counselling with insecure patients and can promote the acceptance of vaccinations.

Recognizing the presence and impact of news outlets' biases on public discourse is a crucial challenge. Biased news significantly shapes how individuals perceive events, potentially jeopardizing public and individual wellbeing. In assessing news outlet reliability, the focus has predominantly centered on narrative bias, sidelining other biases such as selecting events favoring specific perspectives (selection bias). Leveraging machine learning techniques, we have compiled a six-year dataset of articles related to vaccines, categorizing them based on narrative and event types. Employing a Bayesian latent space model, we quantify both selection and narrative biases in news outlets. Results show third-party assessments align with narrative bias but struggle to identify selection bias accurately. Moreover, extreme and negative perspectives attract more attention, and consumption analysis unveils shared audiences among ideologically similar outlets, suggesting an echo chamber structure. Quantifying news outlets' selection bias is crucial for ensuring a comprehensive representation of global events in online debates.

The COVID-19 pandemic is a major public health challenge. The US Centers for Disease Control published guidelines early in the pandemic emphasizing practicing good hygiene and staying at home, which were later modified.

Using a community sample of 2152 participants in the state of Florida who responded to a series of online surveys, we tested a prediction model of adherence to guidelines and intent to vaccinate during the COVID-19 pandemic.

Participants were assessed in May 2020, June 2020, and January 2021. Predictors included sociodemographic and psychological variables.

A slight decrease in adherence was reported over time. In multivariate models, older age, female sex, having health insurance, greater knowledge about COVID-19, more worry, less loneliness, and greater confidence and trust in COVID-19 information were all significantly and consistently associated with greater adherence to guidelines. Significant predictors of intent to vaccinate were male sex, greater knowledge, higher socioeconomic status, identifying as White, and greater guideline adherence (p's < 0.05).

Our findings highlight a number of significant predictors, including knowledge, loneliness, and confidence/trust. Critically these variables are modifiable and could therefore serve as targets in public health interventions to improve adherence to pandemic guidelines in the general population, as well as certain demographic characteristics that may influence intent to vaccinate. COVID-19 knowledge appears to play a central role in both adherence to guidelines and intent to vaccinate suggesting that having accurate information is critical for appropriate behavior.

The global health system remains determined to leverage on every workable opportunity, including artificial intelligence (AI) to provide care that is consistent with patients' needs. Unfortunately, while AI models generally return high accuracy within the trials in which they are trained, their ability to predict and recommend the best course of care for prospective patients is left to chance.

This review maps evidence between January 1, 2010 to December 31, 2023, on the perceived threats posed by the usage of AI tools in healthcare on patients' rights and safety.

We deployed the guidelines of Tricco et al. to conduct a comprehensive search of current literature from Nature, PubMed, Scopus, ScienceDirect, Dimensions AI, Web of Science, Ebsco Host, ProQuest, JStore, Semantic Scholar, Taylor & Francis, Emeralds, World Health Organisation, and Google Scholar. In all, 80 peer reviewed articles qualified and were included in this study.

We report that there is a real chance of unpredictable errors, inadequate policy and regulatory regime in the use of AI technologies in healthcare. Moreover, medical paternalism, increased healthcare cost and disparities in insurance coverage, data security and privacy concerns, and bias and discriminatory services are imminent in the use of AI tools in healthcare.

Our findings have some critical implications for achieving the Sustainable Development Goals (SDGs) 3.8, 11.7, and 16. We recommend that national governments should lead in the roll-out of AI tools in their healthcare systems. Also, other key actors in the healthcare industry should contribute to developing policies on the use of AI in healthcare systems.

This mixed-methods study identified physical activity (PA) and healthy eating messages produced during the COVID-19 pandemic and explored how they were received by UK ethnic minority communities. A scoping review of research and grey literature identified categories of PA and healthy eating messaging targeted at ethnic minorities. Individual and group interviews were conducted, audio-recorded, transcribed and analysed using inductive thematic analysis. There was active community engagement in all study phases to ensure relevance and co-production of findings. Interviews were held with 41 study participants aged 18-86 years (20 men) residing in England and Wales using digital conferencing and in person. The scoping review identified 24 records containing messages grouped into three categories: 1) PA messages; 2) healthy eating messages; 3) risk messages. Five themes described participants' views of these messages: 1) lack of awareness of messaging; 2) responses to PA messaging; 3) responses to healthy eating messaging; 4) perceptions of risk messaging and 5) perceptions of conflict in messages. The review revealed that physical activity and healthy eating messaging specifically targeting ethnic minority communities is limited. This limited messaging was almost entirely missed by these communities. When received, the messaging was not interpreted as intended, perceived to be conflicting and risk messaging was perceived as blaming. More work with ethnic minority communities needs to be done to co-produce meaningful and appropriate PA and healthy eating messaging in a timely manner.