Public information dialogue: understanding information seeking and diffusion Behaviors Regarding the HPV Vaccine

The purpose of this project is to explore the usage of electronic media as a new space of information gathering. By understanding how users negotiate the structures of gathering information, we are better able to understand how mainstream media reproduces a consensual public information dialogue. Specifically, it examines news diffusion of the HPV vaccination by comparing news stories found through Google News and the microblogging site, Twitter. Human papillomavirus (HPV) represents one of the most common sexually transmitted infections. Walboomers, et al. (1999) report that an underestimated 93 percent of invasive cervical cancers worldwide contain HPV. In defense, the Food and Drug Administration (FDA) have introduced two vaccination options, Cervarix and Gardasil, for females interested in guarding themselves against HPV. Medical researchers praise this vaccination and encourage coverage for all females, especially those living in low-income areas with limited access to health care services, a population notoriously difficult in reaching through public health messages (Saslow, et al., 2008). The Center for Disease Control report that as of June 2011, more than 35 million doses of HPV vaccine have been distributed in the United States. However, Levine (2007) explains how mandated vaccination efforts have prompted a widespread backlash across the nation due to its young administration recommendations (girls aged 11 and 12), the possibility of the vaccination encouraging promiscuity among adolescents, and general misconceptions regarding HPV (particularly the cause of Guillian Barre Syndrome). While researchers suggest that strong public health and policy efforts are needed to educate providers, policy-makers, parents, and young women about cervical cancer prevention, these communication efforts have been challenged by US Representative Michele Bachmann. During a recent appearance on the Today Show, Bachmann claimed that a crying woman recently approached her and said that her daughter received the HPV vaccine and developed "mental retardation" (Mulcahy, 2011). The American Academy of Pediatrics (AAP) responded by saying "There is absolutely no scientific validity to this statement". The purpose of this study is to understand Internet dialogue and diffusion surrounding HPV vaccinations, as medical professionals have encouraged increased public health communication since its inception. This analysis will be completed through a comparison of aggregated news stories shared on Google News and Twitter both before, during and after Bachman's appearance on the Today Show to help decipher the sources and spread of citizen-generated content and official news sources. Google News applies topic detection, tracking, article clustering and top-level categoration to over 4,500 news sources, (Lloyd, Kechagias, & Skiena, 2005) making it the most popular sources of information for online news (Das, Datar, Garg & Rajaram, 2007). It is also important to note Google News is able to add and drop new articles every minute. Little competition existed until the microblogging service Twitter launched. Kwak, et al. (2010) explain how over 41 million Twitter users are able to tweet about any topic within the 140-character limit. One of the most popular features of Twitter is the ability for users to 'retweet' stories they find in other user feeds. Research points to this retweeting option as a way to diffuse information regarding headline news (Kwak, Lee, Park, & Moon, 2010). Based on this understanding, researches chose Google News and Twitter as the sources of public information regarding the HPV vaccination. 100 news articles from Google News were analyzed over a three-month period, including the time before, during and after Bachmann's controversial comments. This sample will be compared to 100 articles 'retweeted' on Twitter during the same time period (August - October, 2011) found using the search term "HPV Vaccination". Duplicate articles were only recorded once to increase variety within the sample. Each article was coded for nine key variables: (a) length of the article; (b) date; (c) tone of the article (i.e., positive, neutral, or negative); (d) information sources (i.e., government websites, health organization websites, portal sites, etc.); (e) topics of the article (i.e., vaccine efficacy, dosing, duration, protection against diseases, eligibility, side effect, cost, and other); (f) issues or concerns mentioned in the article (i.e., increasing sexual risk behavior, mandatory school vaccination, importance of continued Pap smears, age concern, safety, accessibility, affordability, and other); (g) vaccine label (i.e., cervical cancer vaccine, HPV vaccine, brand name, STI/STD vaccine, and genital warts vaccine); (h) types of sources referenced in the article (i.e., medical doctors, political and government officials and organizations, CDC, vaccine manufacturer representative, cancer organizations, research community, personal accounts, and other); and (i) interactivity (i.e., hyperlinks, search function, comments, share, and other). All the coding categories are based on the previous literature (e.g., Calloway, et al., 2006; Habel, Liddon, & Stryker, 2009; Johnson, Sionean, & Scott, 2011; Wang & Gantz, 2007). Two experienced and trained coders carried out the coding independently with mutually exclusive definitions of categories (Holsti, 1969). All the news articles were downloaded to a computer hard drive for the purpose of coding and intercoder reliability test, as Google and Twitter frequently update their pages. Approximately 20% of the total sample was randomly selected to access intercoder reliability, including articles from both Google and Twitter, on all nine variables. The cohen's Kappa indicates a high level of reliability on the coding instrument and across coders. Results of this analysis show differences in information gathering and diffusion practices among users. Twitter articles proved shorter, were more positive towards HPV vaccinations and referenced opinion bloggers at a much higher rate than Google News. Google News showcased longer articles, were more neutral regarding HPV coverage and referenced more official sources, such as the CDC and AAP. Research shows how mainstream media, particularly the Internet, reproduces a consensual public information dialogue. By examining news diffusion of the HPV vaccine, this project demonstrates how controversies such as Bachmann's Today Show appearance, sparks new public dialogue. In addition, this study helped us to understand diffusion differences between through Google News and Twitter, particularly regarding the type of information users seek