ABSTRACT Breast cancer is a significant health concern globally, including in Nigeria, where its incidence is rising. An essential component of breast cancer care is the psychosocial wellbeing of patients, which is often shaped by the language used in healthcare and society. While some research has explored stigmatization of breast cancer patients, no study has focused on language as a tool for this stigmatization in Nigeria. This study examines how language perpetuates the stigmatization of breast cancer patients and explores ways to use language to improve their lives and health. Using Norman Fairclough’s model of critical discourse analysis and a descriptive design, data was collected through interviews with 50 respondents at the University College Hospital in Ibadan, Nigeria. The study’s discourse analysis revealed that stigmatization is perpetuated through language, including negative stereotypes, body shaming, spiritual interpretations, and derogatory terms. These discourses reflect broader social and cultural factors such as norms, beliefs, and power dynamics that reinforce stigmatization. The research highlights the effects of stigmatizing language, including denial, loss of femininity, shame, and fear of a new identity. The findings call for policies and interventions to reduce stigma, improve patient experiences, and raise public awareness of breast cancer.

ABSTRACT Communicating genetic information within families living with inherited genetic conditions (IGCs), especially incurable and progressive late-onset neurodegenerative diseases (LONDs), presents significant challenges. To date, no literature review has specifically addressed this issue in families with LONDs. To fill this gap, a scoping review was conducted following PRISMA and JBI guidelines. Four databases (Scopus, Web of Science, PubMed, and PsycInfo) were searched, resulting in 31 articles for analysis. Six categories were identified: (i) from whom to whom: communication transmitters and receivers, (ii) what to tell: content and details of communication, (iii) how to tell: communication approach, (iv) when to tell: timing of communication, (v) barriers and reasons for not communicating, and (vi) facilitators and reasons for communicating. Sharing information about LONDs is a multi-step, deliberative process involving several transmitters and receivers. It typically begins with first-degree relatives, with women often assuming a pivotal role in the gathering and dissemination of information, and extends to the wider family. This process includes assessing the family member’s subjective experiences and the potential impact of the information. Fear of stigmatization and discrimination are notable barriers, while feelings of responsibility and moral obligation toward family members are strong motivators for transmitters to communicate. The studies included in this review were all retrospective, primarily utilized a qualitative design, and predominantly focused on families with Huntington's disease. Prospective studies are needed to investigate disclosure decision-making in families with other LONDs and to explore how the potential availability of clinical trials for testing new drugs might influence family communication.

ABSTRACT Health and health care disparities confronting sexual minority (i.e. non-heterosexual identified) adults are well-documented. Meanwhile, patient-centered communication (PCC) is shown to be effective for health care delivery and health promotion among sexual minority individuals. However, there remains a dearth of research that links PCC and sexual minority adults’ mental health. This study examines the relationship between PCC and mental health among sexual minority adults by focusing on the mediating role of health self-efficacy and the moderating role of eHealth. Data from all non-heterosexual identified respondents (N = 350; mean age = 56.23 years; 65.7% female) of the Health Information National Trends Survey collected in 2017 (HINTS 5 Cycle 1) were analyzed. Results indicate that after controlling for respondents’ age, gender, and education, health self-efficacy mediated the relationship between PCC and mental health. Meanwhile, the mediating effect of health self-efficacy was moderated by eHealth. Findings from this study provide a more precise understanding of the mechanism that underlies the relationship between PCC and sexual minority adults’ mental health as well as inform the development of interventions to address their health care disparities.

ABSTRACT Adolescence and emerging adulthood are developmental periods characterized by increased prevalence of mental health (MH) issues. Disclosure of MH issues to parents or other adults is important for youth to gain support and access professional MH care, but many youth do not disclose MH issues due to a myriad of reasons. In this study, we conducted five focus groups (N = 33) with adolescents and emerging adults to better understand their perceptions of disclosing MH issues to their parents. We used reflexive thematic analysis to identify factors that facilitate MH disclosure to parents and improve the process of discussing concerns. Our analysis identified six themes which include relational assessment, barriers to disclosure, MH literacy, disclosure anxiety, boundaries and communication, and access to services. Our findings are discussed in the context of disclosure decision-making models and how professionals can equip parents to create a parent–child relationship conducive to MH disclosure.

ABSTRACT UK national guidelines recommend how healthcare professionals should communicate with patients. However, the impact of following, or violating, these guidelines on how much the healthcare professional is respected, liked, or trusted, and the mechanisms underpinning, and consequences of, these perceptions have not been tested. To address these gaps, two UK-based, pre-registered studies using within-subjects designs required participants to rate how much they respect, like and trust general practitioners (GPs), as well as how competent, assertive, moral, and warm they are, and their commitment to adhere to their advice. After these baseline assessments, participants were presented with a series of vignettes where hypothetical GPs violated (Study 1, N = 329, and Study 2, N = 329) and followed (Study 2 only) recommended communication guidelines. Violations reduced respect for GPs more than liking and liking more than trust. Following communication guidelines increased liking for GPs the most followed by trust and respect the least. Violations of, and following, communication guidelines impacted (reduced/increased, respectively) patients’ commitment to treatment adherence via trust, primarily, as well as respect. Summarizing information and checking patients have understood the most important information impacted how GPs were evaluated more than the other tested communication recommendations, suggesting this specific recommendation could be prioritized over the other tested recommendations. Furthermore, by impacting how much patients trust and, to a lesser extent, respect their GP, how committed patients are to following treatment advice could be affected by how GPs communicate with their patients.

ABSTRACT As COVID-19 vaccination hesitancy remains a major public health issue, understanding the factors influencing attitudes and COVID-19 vaccination intentions is a public health priority. Applying the theory of planned behavior (TPB), this study examined the role of two forms of social trust – namely, particularized trust toward relationally close others and generalized trust toward people in general – in moderating the relationship between social norms (injunctive and descriptive) and COVID-19 vaccination attitudes and intent. In two studies (n = 235 for Study 1, n = 273 for Study 2, total N = 508), we found some support for the TPB in the context of COVID-19 vaccination, with attitudes and injunctive norms significantly predicting vaccination intention. However, perceived behavioral control was not a significant predictor of COVID-19 vaccination intention. Extending the TPB, we found that trust in others had an amplifying effect on the relationship between descriptive norms and COVID-19 vaccination attitudes. However, trust attenuated the link between injunctive norms and attitudes toward COVID-19 vaccination. The implications of these findings are discussed.

ABSTRACT It is known that older adults are more susceptible to misinformation, and older adults sharing health misinformation is a growing concern. This study explores the factors influencing health misinformation sharing and relational correction among Chinese older adults from a cultural perspective. Guided by the PEN-3 cultural model, we conducted focus groups and in-depth interviews with 79 participants in China to understand the cultural and contextual factors of misinformation sharing. We found that (a) older adults actively shared health misinformation influenced by negative factors such as values of familial ties, need for respect, reciprocity, and initiation of conversation; (b) existential factors such as fact-checking tendency; (c) positive factors such as fatal information avoidance, political identify, awareness of marketing targeting, and social responsibility. Additionally, we found that older adults tend to switch to a silent mode of relational correction for factors such as harmony and face. This research extends the model’s applicability and provides localized insights for developing culturally sensitive health communication strategies to mitigate the spread of health misinformation.

ABSTRACT This study examined the potential role of binge drinking status in moderating the persuasive effects of narrative versus non-narrative pictorial warning labels (PWLs). In an online longitudinal experiment involving moderate and heavy drinkers, we found that the interaction between binge drinking status and PWL type was significant for intentions to reduce and stop drinking upon immediate PWL exposure (N = 649) and at two-week follow-up (N = 598). Among non-binge drinkers, narrative (vs. non-narrative) PWLs led to higher intentions to reduce drinking upon immediate exposure and higher intentions to stop drinking at two-week follow-up. Among binge drinkers, non-narrative (vs. narrative) PWLs resulted in higher intentions to stop drinking upon immediate exposure and at two-week follow-up. In addition, our results revealed that narrative PWLs increased behavioral intentions through heightening cognitive elaboration and retrospective reflection among non-binge drinkers, while non-narrative PWLs improved intentions only through enhancing retrospective reflection among binge drinkers. These results indicate that the effectiveness of narrative versus non-narrative PWLs depends on individuals’ drinking habits.

ABSTRACT This study aimed to explore the dissemination of HIV/AIDS-related information and risk factors on social media during AIDS Weeks, helping policymakers and public health organizations understand how the public utilizes social media to formulate strategies for AIDS health campaigns better. This study used Latent Dirichlet Allocation (LDA) topic modeling and sentiment analysis to investigate the distribution of themes and people’s reactions during AIDS Weeks. Additionally, Critical Discourse Analysis (CDA) was employed to further examine the social structures, cultural contexts, and power dynamics underlying the discourse. From 2018 to 2021, 48437 posts were analyzed, revealing 21 topics coded and categorized into six main themes: Response Methods, Specific Topics, Promotion, Virus Status, Specific Groups, and Positive Feedback. Critical discourse analysis uncovered a parallel trend of demonstrating both threat and efficacy in AIDS Week promotion in China. However, the lack of actionable prevention information may reduce behavioral intentions. The top-down implementation approach ensures efficient execution at all levels but also results in formalism during AIDS Week. Text themes vary annually based on slogans and social contexts, requiring localization for effective implementation and overcoming cultural barriers detrimental to health promotion. Cultural context and social structures contribute to issues such as formalism and stigmatization of marginalized groups. We suggest enhancing user engagement and interaction through social platforms during AIDS Week activities. Collaboration between public health organizations and social media companies can further increase public awareness of the disease, mitigate societal biases, and provide accurate and practical prevention guidance.