BACKGROUND: Recruiting participants for clinical trials poses challenges. Major barriers to participation include psychological factors (eg, fear and mistrust) and logistical constraints (eg, transportation, cost, and scheduling). The strategic design of clinical trial messaging can help overcome these barriers. While strategic communication can be done through various channels (eg, recruitment advertisements), health care providers on the internet have been found to be key sources for communicating clinical trial information to US adults in the social media era.
OBJECTIVE: This study aims to examine how communication source (ie, medical doctors and peers) and message framing of TikTok videos (ie, psychological and logistical framing) influence clinical trial-related attitudes, perceptions, and sign-up behaviors under the guidance of the integrated behavioral model.
METHODS: This study used a 2 (source: doctor vs peer) × 2 (framing: psychological vs logistical) between-participant factorial design web-based experiment targeting adults in the United States who had never participated in clinical trials (ie, newcomers). A Qualtrics panel was used to recruit and compensate the study respondents (n=561). Participants viewed short-form videos with doctors or peers, using psychological or logistical framing. The main outcome measures included perceived source credibility, self-efficacy, attitude toward clinical trial participation, behavioral intention, and sign-up behavior. Structural equation modeling was used to analyze the direct and indirect effects of message factors on the outcome variables. Source (doctor=1; peer=0) and framing (psychological=1; logistical=0) were dummy-coded.
RESULTS: Doctor-featured messages led to greater perceived source credibility (β=.31, P<.001), leading to greater self-efficacy (95% CI 0.13-0.30), which in turn enhanced behavioral intention (95% CI 0.12-0.29) and clinical trial sign-up behavior (95% CI 0.02-0.04). Logistical barrier-framed messages led to greater self-efficacy (β=-.09, P=.02), resulting in higher intention to participate in clinical trials (95% CI -0.38 to -0.03) and improved sign-up behavior (95% CI -0.06 to -0.004). Logistical barrier-framed messages were also directly associated with an increased likelihood of signing up for a clinical trial (β=-.08, P=.03). The model accounted for 21% of the variance in clinical trial sign-up behavior. Attitude did not significantly affect behavioral intention in this study (β=.08, P=.14), and psychological and logistical barrier-framed messages did not significantly differ in attitudes toward clinical trial participation (β=-.04, P=.09).
CONCLUSIONS: These findings advance our understanding of how people process popular message characteristics in short-form videos and lend practical guidance for communicators. We encourage medical professionals to consider short-form video sites (eg, TikTok and Instagram Reels) as effective tools for discussing clinical trials and participation opportunities. Specifically, featuring doctors discussing efforts to reduce logistical barriers is recommended. Our measuring of actual behavior as an outcome is a rare and noteworthy contribution to this research.

Predictions and estimates are sometimes qualified as certain. This epistemic marker occupies a privileged position at the top of scales of verbal probability expressions, reflecting probabilities close to 1. But such statements have rarely been compared to plain, unqualified statements in which certainty is not mentioned. We examined in nine studies (N = 2784) whether statements explicitly claimed to be certain are perceived as (1) more (or less) credible, (2) more (or less) precise, and (3) more (or less) strongly based upon evidence, compared to plain, unmarked declarative statements. We find, in apparent contrast with assumptions made by the standard scales, that \"certain\" are often judged to be less trustworthy, less reliable, and held with lower confidence than unmarked statements. Plain, declarative statements are further assumed to be more precise, while certainty implies that more extreme outcomes are possible. When it is certain that Henry made four errors, it is clear he did not commit less than four, but he might have committed five errors or more. Thus certainty can indicate lower bounds of an interval whose upper bounds are not defined, and certainty statements are consequently more ambiguous than estimates that do not mention certainty. At least-interpretations of certainty affect the interpretation of options in risky choice problems, where \"200 lives will be saved\" was deemed by a majority to mean exactly 200, while \"it is certain that 200 will be saved\", could mean 200-600 lives. We also find that credibility is affected by type of certainty, with impersonal certainty (\"it is certain\") perceived to be more accurate and persuasive than personal certainty (\"I am certain\"), especially in predictions of future events. Moreover, mentions of certainty can reveal that that a speaker\'s estimate is based on subjective judgments and guesswork rather than upon objective evidence. These findings have implications for communication. Estimates can appear more consensual when claims of certainty are omitted. To convey certainty it may be better not to mention that one is certain.

Inequality is often one-sidedly framed as disadvantage, a practice identified as problematic by empirical research and critical scholarship, as it renders privilege invisible and shapes perceptions of and reactions to inequality. Importantly, inequality can mean differences in positive (e.g., promotions) or negative outcomes (e.g., harassment). Drawing on cognitive processes involved in (group) comparisons and the processing of positive and negative content, we predict that the valence of outcomes moderates the preference for disadvantage (vs. advantage) frames. We coded social media posts on gender inequality (Study 1, n = 1,402) and had participants in an online experiment (Study 2, n = 164) describe gender and sexual orientation inequality in positive and negative outcomes. Confirming hypotheses, people overall used disadvantage frames more, but were more likely to use advantage frames for inequality in positive (compared with negative) outcomes. We discuss theoretical implications for inequality framing research and practical implications for privilege awareness interventions.

Nudges can be an effective strategy to promote vaccination. However, it is necessary to better identify the characteristics of nudges that produce the strongest effects and how they interact with individuals\' attitudes. Here we sequentially test the effectiveness of three nudge characteristics (framing, nudge type, and presentation modality) and the role of participants\' attitudes toward Covid-19 vaccination, social solidarity and authoritarianism in vaccination decisions. In studies 1-4, participants were presented with a nudge manipulating a target characteristic (e.g. positive/negative framing, nudge type) and measuring willingness to vaccinate and related variables compared a control nudge. Study 5 used a single combined nudge reflecting the combination of successful nudges in previous studies. Results over all studies show that nudging has unreliable effects while vaccine attitudes are more reliably linked to all measures of vaccines willingness. These results suggest that attitudes play a more reliable role on effective adoption of vaccinations.

BACKGROUND: National food environment policies can contribute to the reduction of diet-related non-communicable diseases. Yet, their implementation in the Netherlands remains low. It has been hypothesized that the media can play a pivotal role in inducing spikes in policy attention, thereby shaping political action. The aim of this study was to examine the discourse on food policies in Dutch newspaper articles between 2000-2022, by analyzing arguments used by various actors.
METHODS: A systematic search in Nexis Uni was used to identify newspaper articles that covered national-level Dutch food environment policies published in seven Dutch national newspapers between 2000-2022. Covered policies were classified into six domains including food composition, labeling, promotion, prices, provision and retail and into the four stages of the policy cycle; policy formulation, decision-making, implementation, and evaluation. A grey literature search was used to identify food policies implemented during 2000-2022. Descriptive statistics were used to summarize coverage of policies over time, policy type and policy stage. An interpretive content analysis was performed on a random subsample of the newspaper articles to determine the actors, viewpoints and arguments of the food policies.
RESULTS: We identified 896 relevant newspaper articles. The coverage of food policies in newspapers was initially low but peaked in 2018/2021/2022. Through grey literature search we identified 6 food policies which were implemented or adjusted between 2000-2022. The majority of the newspaper articles reported on food pricing policies and were discussed in the policy formulation stage. Academics (mainly supportive) were the most and food industry (mostly opposing) the least cited actors. Supportive arguments highlighted health consequences, health inequalities and collective responsibility, whereas opposing arguments focused on unwanted governmental interference and ineffectiveness of policies.
CONCLUSIONS: Dutch newspaper articles covering food policies represented a variety of actors and arguments, with individual versus collective responsibility for food choices playing a central role in the arguments. These insights may serve as a basis for further research into why certain arguments are used and their effect on policy attention and implementation.

In the adolescent mental health crisis, negative narrative communication has unitended consequences. Supportive communication involves reframing communications to find a new narrative that does not evoke biases. This narrative must emphasize agency and highlight the strengths, potential, and common experiences of young people. It is clear that supporting positive development and well-being is an \"us\" endeavor. There is a place in this communication strategy for pediatric professionals to address young people, caregivers, other health care professionals, and the community. The science of framing helps us shape a more supportive and productive discourse.

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Robot technologies could lead to radical changes in farming. But what does the public know and think about agricultural robots? Recent experience with other agricultural technologies-such as plant genetic engineering-shows that public perceptions can influence the pace and direction of innovation, so understanding perceptions and how they are formed is important. Here, we use representative data from an online survey (n = 2269) to analyze public attitudes towards crop farming robots in Germany-a country where new farming technologies are sometimes seen with skepticism. While less than half of the survey participants are aware of the use of robots in agriculture, general attitudes are mostly positive and the level of interest is high. A framing experiment suggests that the type of information provided influences attitudes. Information about possible environmental benefits increases positive perceptions more than information about possible food security and labor market effects. These insights can help design communication strategies to promote technology acceptance and sustainable innovation in agriculture.

BACKGROUND: Suicide is a leading cause of death worldwide. Journalistic reporting guidelines were created to curb the impact of unsafe reporting; however, how suicide is framed in news reports may differ by important characteristics such as the circumstances and the decedent\'s gender.
OBJECTIVE: This study aimed to examine the degree to which news media reports of suicides are framed using stigmatized or glorified language and differences in such framing by gender and circumstance of suicide.
METHODS: We analyzed 200 news articles regarding suicides and applied the validated Stigma of Suicide Scale to identify stigmatized and glorified language. We assessed linguistic similarity with 2 widely used metrics, cosine similarity and mutual information scores, using a machine learning-based large language model.
RESULTS: News reports of male suicides were framed more similarly to stigmatizing (P<.001) and glorifying (P=.005) language than reports of female suicides. Considering the circumstances of suicide, mutual information scores indicated that differences in the use of stigmatizing or glorifying language by gender were most pronounced for articles attributing legal (0.155), relationship (0.268), or mental health problems (0.251) as the cause.
CONCLUSIONS: Linguistic differences, by gender, in stigmatizing or glorifying language when reporting suicide may exacerbate suicide disparities.

To elicit compassion and communicate urgency to policy makers and governments, researchers and program developers have promoted a narrative of vulnerability and risk to frame the experience of families when parents have been diagnosed with mental illness. Developed within a western medicalised socio-cultural context, this frame has provided a focus on the need for prevention and early intervention in service responses while also unintentionally \'othering\' these families and individualizing the \'problem\'. This frame has had some unintended consequences of seeing these families through a deficit-saturated lens that misses strengths and separates family members\' outcomes from each other. This paper raises questions about the continued fit of this frame and suggests a need to reimagine a new one.