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What have we learned about communication inequalities during the H1N1 pandemic: a systematic review of the literature
Open accessAbstract
BACKGROUND: During public health emergencies, public officials are busy in developing communication strategies to protect the population from existing or potential threats. However, a population's social and individual determinants (i.e. education, income, race/ethnicity) may lead to inequalities in individual or group-specific exposure to public health communication messages, and in the capacity to access, process, and act upon the information received by specific sub-groups- a concept defined as communication inequalities.The aims of this literature review are to: 1) characterize the scientific literature that examined issues related to communication to the public during the H1N1 pandemic, and 2) summarize the knowledge gained in our understanding of social determinants and their association with communication inequalities in the preparedness and response to an influenza pandemic. METHODS: Articles were searched in eight major communication, social sciences, and health and medical databases of scientific literature and reviewed by two independent reviewers by following the PRISMA guidelines. The selected articles were classified and analyzed in accordance with the Structural Influence Model of Public Health Emergency Preparedness Communications. RESULTS: A total of 118 empirical studies were included for final review. Among them, 78% were population-based studies and 22% were articles that employed information environment analyses techniques. Consistent results were reported on the association between social determinants of communication inequalities and emergency preparedness outcomes. Trust in public officials and source of information, worry and levels of knowledge about the disease, and routine media exposure as well as information-seeking behaviors, were related to greater likelihood of adoption of recommended infection prevention practices. When addressed in communication interventions, these factors can increase the effectiveness of the response to pandemics. CONCLUSIONS: Consistently across studies, a number of potential predictors of behavioral compliance to preventive recommendations during a pandemic were identified. Our findings show the need to include such evidence found in the development of future communication campaigns to ensure the highest rates of compliance with recommended protection measures and reduce communication inequalities during future emergencies.
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“Previous studies have suggested negative associations between the extent of communication inequality and countries’ outbreak preparedness,49,52 hindering the effectiveness of containment efforts and weakening societies’ capability in response to health emergencies.53–55”
From Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response (2020) · cites this paper as [52]
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Metadata
- Authors
- Lin, L., Savoia, E., Agboola, F., & Viswanath, K.
- Affiliations
- Harvard University (US)
- Corresponding author
- Lin, Leesa
- Venue
- BMC Public Health
- Published
- 2014-05-21
- Volume
- 14
- Issue
- 1
- Pages
- 484-484
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC4048599
- OpenAlex
- W2120568830
- Cited by
- 228
- References
- 75
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 31 · 2023: 30 · 2022: 43 · 2021: 53 · 2020: 38 · 2019: 1 · 2018: 4 · 2017: 6 · 2016: 7 · 2015: 3
- FWCI
- 3.27
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- U.S. Department of Health and Human Services
- Centers for Disease Control and Prevention (5PO1TP000307-05, 5p01tp000307-05)
- Topics
- Social Sciences › Communication › Public Relations and Crisis Communication
- Social Sciences › Communication › Communication and COVID-19 Impact
- Social Sciences › Sociology and Political Science › Risk Perception and Management
- Keywords
- communication inequalities, H1N1 pandemic, pandemic influenza preparedness, social determinants, health communication, information sources, worry, health knowledge, media exposure, information seeking, infection prevention practices, compliance behavior
- MeSH terms
- Humans, Influenza, Human, Health Knowledge, Attitudes, Practice, Public Health, Research Design, Socioeconomic Factors, Influenza A Virus, H1N1 Subtype, Healthcare Disparities, Health Communication, Pandemics
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