Description
Research Question: How do targeted public relations campaigns within the alcohol industry influence consumer purchasing decisions in different demographic groups?
Write Primary research by using the method case study. The following attachment is case study outline and three brand needed to be analyzed. Mainly analyze how these brands’s public relations campaign did during covid-19. Mainly write two part:
Chapter 1 Findings
Presentation of results.
Chapter 2 Analysis
Implications for thesis proposition/problem statement.
Interpretation of results.
Qualitative (case study)
o Develop areas of conversation based on your questions.
o What are the common themes?
o What are the clear areas of contrast?
o What are the most important or influential verbatims?
o What questions are you left with?
Requirement: 12-font, TIMES NEW ROMA, DOUBLE SPACE, APA CITATION
attachment is one example you can take a look and case study outline
Unformatted Attachment Preview
Seton Hall University
eRepository @ Seton Hall
Seton Hall University Dissertations and Theses
(ETDs)
Seton Hall University Dissertations and Theses
Spring 5-25-2022
Examining the Intersection of Public Relations and Vaccine
Communication: An Analysis of Audience-Centered Strategies for
Evolving Health Information
Julia A. Mills
[email protected]
Follow this and additional works at: https://scholarship.shu.edu/dissertations
Part of the Health Communication Commons, and the Public Relations and Advertising Commons
Recommended Citation
Mills, Julia A., “Examining the Intersection of Public Relations and Vaccine Communication: An Analysis
of Audience-Centered Strategies for Evolving Health Information” (2022). Seton Hall University
Dissertations and Theses (ETDs). 3009.
https://scholarship.shu.edu/dissertations/3009
Examining the Intersection of Public Relations and Vaccine Communication:
An Analysis of Audience-Centered Strategies for Evolving Health Information
Julia Ashley Mills
Seton Hall University
Master’s Project Primary Adviser: McKenna Schray, Ph.D.
Submitted in partial fulfillment of the requirements
for the Master of Arts in Communication
Seton Hall University
South Orange, NJ 07079
2022
© 2022 Julia Ashley Mills
SETON HALL UNIVERSITY
COLLEGE OF COMMUNICATION AND THE ARTS
GRADUATE STUDIES
APPROVAL FOR SUCCESSFUL PRESENTATION
Master’s Candidate, Julia Ashley Mills, has successfully presented and made the required
modifications to the text of the master’s project for the Master of Arts degree during this
Spring 2022 semester.
Primary Adviser:
ADVISER(S) COMMITTEE
McKenna Schray
______________________________________________________________________________
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Signature
Date
Adviser:
Renee Robinson
______________________________________________________________________________
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Adviser:
Ruth Tsuria
______________________________________________________________________________
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Adviser:
Gregory Stevens
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The adviser and any other committee members who wish to review revisions will sign and date this document only when
revisions have been completed. Please return this form to your Academic Advis0r, where it will be placed in the candidate’s
file and submit a copy with your final project to be bound as page number two.
Dedication
This research project is dedicated to my family, friends, and professors at Seton Hall.
First, I would like to thank my family for being my sounding board, energy source, and support
system. I would also like to thank the good friends I made in my cohort these past two years. I
will never forget the hours of proofreading and Saturday lunches. Lastly, I would like to thank
my faculty advisor, Dr. Schray, and the rest of the thesis committee for encouraging me to reach
new heights in my public relations research.
i
Abstract
In an uncertain environment, public relations (PR) practitioners provide signposts to
fulfill different audience information needs. However, little research exists on the role of the PR
practitioner in communicating evolving health information, especially during urgent health
events like a pandemic. Through a comparative case study of PR tactics by three American
public health organizations, this project aimed to understand what strategies health care
professionals can use to improve communication about the COVID-19 vaccine to priority
populations. The findings then informed an original artifact with six best practices for audiencecentered vaccine communication.
Keywords: public relations, public health, vaccine, priority populations, United States,
case study
ii
Table of Contents
Dedication ……………………………………………………………………………………………………………………… i
Abstract………………………………………………………………………………………………………………………… ii
List of Tables and Figures …………………………………………………………………………………………….. vi
Chapter 1: Statement of the Problem …………………………………………………………………………….. 1
Introduction ………………………………………………………………………………………………………………… 1
Problem Statement ………………………………………………………………………………………………………. 3
Purpose of the Study ……………………………………………………………………………………………………. 4
Summary ……………………………………………………………………………………………………………………. 5
Chapter 2: Literature Review ………………………………………………………………………………………… 7
Introduction ………………………………………………………………………………………………………………… 7
Methods for Research Inclusion …………………………………………………………………………………….. 8
Overview of Uses and Gratification Theory ……………………………………………………………………. 9
Intersection of Uses and Gratification Theory and Health Communication ……………………….. 10
Uses ……………………………………………………………………………………………………………………… 10
Gratifications …………………………………………………………………………………………………………. 12
Significance of Effective Messaging in Health Communication ………………………………………. 12
Audience Needs ……………………………………………………………………………………………………… 13
Audience Values …………………………………………………………………………………………………….. 14
Audience Experiences …………………………………………………………………………………………….. 14
Traditional PR …………………………………………………………………………………………………………… 16
Function of PR in Generating Effective Messaging………………………………………………………… 16
History of Vaccine Communication ……………………………………………………………………………… 18
Role of PR Expert in Vaccine Communication ……………………………………………………………… 21
Summary ………………………………………………………………………………………………………………….. 23
Chapter 3: Methods …………………………………………………………………………………………………….. 26
Introduction ………………………………………………………………………………………………………………. 26
Statement of the Problem ……………………………………………………………………………………………. 26
Method Description ……………………………………………………………………………………………………. 27
Data Collection ………………………………………………………………………………………………………….. 28
Data Analysis ……………………………………………………………………………………………………………. 30
iii
Coding Categories ……………………………………………………………………………………………………… 31
Audience Needs ……………………………………………………………………………………………………… 31
Audience Values …………………………………………………………………………………………………….. 31
Audience Experiences …………………………………………………………………………………………….. 31
Population Identifiers ……………………………………………………………………………………………… 32
Traditional Public Relations …………………………………………………………………………………….. 32
Limitations of the Study ……………………………………………………………………………………………… 32
Summary ………………………………………………………………………………………………………………….. 33
Chapter 4: Findings …………………………………………………………………………………………………….. 34
Introduction ………………………………………………………………………………………………………………. 34
Findings on Traditional PR Strategies for American Health Organizations ……………………….. 36
Before the COVID-19 Vaccine Rollout ………………………………………………………………………… 36
CDC ……………………………………………………………………………………………………………………… 37
APHA …………………………………………………………………………………………………………………… 38
HCA Healthcare …………………………………………………………………………………………………….. 39
After COVID-19 Vaccine Rollout ……………………………………………………………………………….. 39
CDC ……………………………………………………………………………………………………………………… 39
APHA …………………………………………………………………………………………………………………… 40
HCA Healthcare …………………………………………………………………………………………………….. 41
Comparative Analysis ………………………………………………………………………………………………… 42
Audience Responsibility ………………………………………………………………………………………….. 44
Audience Action …………………………………………………………………………………………………….. 45
Audience Expectation ……………………………………………………………………………………………… 45
Summary ………………………………………………………………………………………………………………….. 46
Chapter 5: Discussion ………………………………………………………………………………………………….. 47
Introduction ………………………………………………………………………………………………………………. 47
Findings on Traditional PR Strategies for Priority Populations ………………………………………… 47
Controlling Information …………………………………………………………………………………………… 48
Sharing Resources ………………………………………………………………………………………………….. 49
Building Relationships and Setting Context ……………………………………………………………….. 50
Recommendations ……………………………………………………………………………………………………… 52
Strengths and Limitations of the Study …………………………………………………………………………. 54
Suggestions for Future Research ………………………………………………………………………………….. 54
Conclusion ………………………………………………………………………………………………………………… 55
iv
References …………………………………………………………………………………………………………………… 57
Appendix A …………………………………………………………………………………………………………………. 69
v
List of Tables and Figures
Table 4.1: Coding Categories…………………………………………………………………………………………. 36
Figure 4.1: Word Cloud Depicting the CDC Facebook Posts …………………………………………….. 38
Figure 4.2: Word Cloud Depicting the APHA Facebook Posts ………………………………………….. 41
Figure 4.3: Word Cloud Depicting the HCA Healthcare Facebook Posts…………………………….. 42
Figure 4.4: Bar Chart Depicting the Number of Facebook Shares Across Organizations ………. 44
Figure 5.1: CDC Facebook Posts for December 15 and 21 ………………………………………………… 51
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EXAMINING THE INTERSECTION OF PUBLIC RELATIONS
Chapter 1
Statement of the Problem
Introduction
In an increasingly digital world, people rely on online sources to complement or augment
their understanding of health information. According to a recent survey by the American Health
Information Management Association (AHIMA) Foundation, almost 62% of Americans reported
not feeling confident in the health information they discuss with their doctors (AHIMA
Foundation, 2021). Urgent health events increase the risk associated with uncertainty. In
particular, the ongoing coronavirus (COVID-19) pandemic embodies such risk due to the rapid
loss of life. Personal health care providers functioned as the most trusted source of information
on the initial rollout of the COVID-19 vaccine (Hamel et al., 2020). However, due to limited
accessibility and constantly changing data, people turned to traditional media—often accessible
in online formats—to find additional clarity during the pandemic response (Piltch-Loeb et al.,
2021).
The United States spends more of its gross domestic product on health care services than
any industrialized nation (Nunn et al., 2020; Wise, 2001). Government public health services
include epidemiological surveillance, inoculations, immunization/vaccination services, disease
prevention programs, and public health laboratory operations (Kamal et al., 2020). Yet, only 5%
of Americans represented half of U.S. health care spending in 2017, mainly for personal needs
like unexpected health conditions and emergencies (Nunn et al., 2020). Generally, populationbased services account for the lowest portion of health spending (Wise, 2001).
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EXAMINING THE INTERSECTION OF PUBLIC RELATIONS
To fill the gap in population-based resources, health care delivery has intertwined with
digital communication technologies like websites more (Hu, 2015). To date, 59% of Americans
reported contacting their doctors directly, while roughly the same number chose the Internet to
find the information they sought (AHIMA Foundation, 2021). As Internet access expands, more
people select it as a primary source of health information. However, the Internet presents
challenges for health users who need understandable and trustworthy information (Patterson et
al., 2015).
During the urgent COVID-19 pandemic, American health journalists also struggled to
accommodate increased population interest and readership for health reporting (Yang, 2021).
Strained public health resources impact the quality of public information officer (PIO)-health
journalist relationships during emergency health events (Avery & Lariscy, 2007). So, journalists
tried to tackle the shortage by sharing more resources. In that way, they could quickly identify
correct information rather than simply increase share of voice (Yang, 2021). Regardless of the
shift, Avery and Lariscy (2007) warned that receiving publics can still suffer negative effects
from the discoordination or divergent agendas of journalists and information officers, especially
in health situations that require timely action. Vardeman-Winter et al. (2013) also noted that an
inherent balance emerges when more laypeople exist than decision-makers. Those information
barriers result from static and monolithic media relations strategies (Avery & Lariscy, 2007).
As such, health care communicators should spearhead efforts to create a standard of
excellence in audience-centered health communication. Trusted sources function as tools of
influence for instruction-based information (e.g., receiving a vaccine). Communication best
practices become essential for receivers that cannot follow general health recommendations like
priority populations. According to the Agency for Healthcare Research and Quality, there has
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EXAMINING THE INTERSECTION OF PUBLIC RELATIONS
been a lag in research regarding priority populations, including low-income members, racial or
ethnic minorities, women, children and adolescents, elderly persons, and individuals with special
health care needs (About Priority, n.d.). General health message designs may not adequately
address the complex health needs of those groups, considering the transient nature of information
in fast-paced and evolving health environments. The relatively recent practice of digital
segmentation or “the ability to sort and reach audiences in a targeted manner using digital
technologies” (Evans et al., 2019, p. 82S) provides better opportunities to satisfy their needs.
Generally, few guidelines exist on strategically employing digital segmentation in public health.
As such, individuals who practice public relations (PR), “a service-oriented occupation in which
public interest, not personal reward, should be the primary consideration” (Newsom et al., 2013,
p. 4), could be equipped to address the gap.
Problem Statement
As humans navigate novel and unforeseen health guidance (e.g., instructions during
public health crises), they need reliable actors to create clear signposts for media content. In
particular, PR practitioners should be at the forefront. They can serve as leaders that initiate
strategic actions for underrepresented populations and leverage the value of PR in health care
(Meng & Berger, 2013). Additionally, they influence immediate perceptions of trust and
credibility, which holds broader implications for audience members returning to the same media
channels for future health developments. Some researchers suggest that PR professionals are the
most qualified to assess appropriate ways of informing audiences about a developing health
environment, primarily new medical services and technologies like vaccines (Elrod &
Fortenberry, 2020). However, little research exists on the role of current PR professionals in
communicating developing health information.
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EXAMINING THE INTERSECTION OF PUBLIC RELATIONS
The PR field needs to understand how to assist vulnerable populations with adaptations to
health care delivery. Generally, industry professionals carry more substantial expectations to be
timely and transparent. For example, the two-way communication model practiced in the PR
field responds to the dynamic requirements of receivers. In the twenty-first century, modern
health PR has focused on the interactional nature of media, enabling patients to communicate
about health needs while simultaneously seeking new information (Tomic et al., 2010). By
enabling two-way communication, PR practitioners can improve audience confidence and
comprehension of further details (Catalan-Matamoros & Peñafiel-Saiz, 2019).
Purpose of the Study
Given the struggle to serve audience-centered health information needs, this project
sought to determine how well the complex and dynamic information needs were represented for
priority populations in the U.S. during the COVID-19 vaccine rollout. The project also
endeavored to understand better the role of PR practitioners as mediators of evolving health
practices and their specific involvement with targeted health care delivery. Considering they
function as subject or specialization experts, they have the capacity to take on leadership
positions in educating key publics and disseminating evolving knowledge.
By investigating the American COVID-19 pandemic response, this project contributed to
knowledge about user experiences with new health information. For example, priority
populations like women may need to engage in behaviors that balance protecting their own
health and that of dependents like children (Newsom et al., 2013). Considering PR professionals
conduct continuous research on receiving audiences, they can more effectively respond to
insights on multi-faceted health needs. Alternatively, the findings instructed PR practitioners on
applying their training to assess the shortcomings in audience-centered communication and
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EXAMINING THE INTERSECTION OF PUBLIC RELATIONS
ultimately strengthen the relationship between impacted groups and health care authorities.
Finally, the research guided best practices for shaping the media’s educational role during a
shifting health context (e.g., life-threatening disease outbreak and urgent response).
PR professionals specifically develop the competence and knowledge to deal with rapidly
changing environments (Meng & Berger, 2013). Following the declaration of COVID-19 as a
pandemic, journalists struggled to evolve into health reporters overnight (Yang, 2021). In those
cases, PR practitioners can step in to expose impacted populations to the information and
communication tools they need to actively manage the health environment. They can lead with
specialized expertise as others navigate a new or limited understanding of the facts. In addition,
they can provide a roadmap for digital health information, which varies significantly between
content and quality (Patterson et al., 2015). Therefore, the research should empower those
professionals and help them understand how to use their skills and abilities in health care
delivery.
Summary
This research project consists of five chapters that explore the relationship between
vaccine delivery and PR best practices. To begin, Chapter 1 outlines the problem and proposes a
structure for the rest of the thesis. Chapter 2 reviews the scholarly literature on traditional PR,
strategic health messaging, and vaccine communication. Chapter 3 describes the comparative
case study and textual analysis used to collect data. Chapter 4 details the project’s findings.
Finally, Chapter 5 discusses the successes and limitations of the research to inform future
projects and presents the culminating artifact.
Having completed an overview of vaccine literature in Chapter 2, a gap emerged in the
research. Studies did not assess the ongoing compatibility of health information for vulnerable
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EXAMINING THE INTERSECTION OF PUBLIC RELATIONS
populations functioning in changing environments like the COVID-19 pandemic crisis. The
project endeavored to address the gap by discussing the value of PR in audience-centered health
care delivery, especially considering the dependence on Internet sources. As such, the following
two questions were considered:
RQ1: What traditional PR strategies do American health organizations employ to
communicate about vaccines to different U.S. publics?
RQ2: How did those PR strategies change when communicating about the COVID-19
vaccine to priority populations during the pandemic crisis?
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EXAMINING THE INTERSECTION OF PUBLIC RELATIONS
Chapter 2
Literature Review
Introduction
Mass media serve as a leading source for directed health behaviors like getting a vaccine
(Chen & Stoecker, 2020). The mass media, which encompass newspapers, magazines, radio, and
television (Wilcox et al., 2015), significantly impact health knowledge or perceptions of health
knowledge (Volkman et al., 2021). Individuals or groups interact with media channels for
different reasons. Uses and gratification theory not only analyzes how audiences select the
content or communication sources but how they shape the media channels disseminating those
messages. Even if a particular media outlet serves as a useful public education tool, the receiving
audience can decrease its effectiveness based on a lack of appreciation or acceptance (Dixon &
Clarke, 2012). The boundaries of media channels such as the limited amounts of space for
technical explanation or competing functions of journalists in sharing new health practices factor
into the evaluation of information (Catalan-Matamoros & Peñafiel-Saiz, 2019). In light of the
dynamic relationship, this literature review explores the influences of media channels and
audiences on public health communication with a particular focus on vaccine messages.
First, the literature review provides an overview of the uses and gratification theory.
Then, it focuses on the particular intersection of the theory with health communication, breaking
down the difference between uses and gratifications. Later, it explores the qualities of an active
audience based on the selection of mass media channels. Finally, the review discusses the
function of PR in health messaging, with a special focus on messages grounded in instructions,
guidelines or directives. The literature also explicitly highlights studies on vaccine
communication.
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EXAMINING THE INTERSECTION OF PUBLIC RELATIONS
Methods for Research Inclusion
To begin the investigation, online library databases and Google Scholar were searched
for peer-reviewed, academic journal articles that explored uses and gratification theory, vaccine
or public health communication, and the use of PR in health messaging. Websites, dissertations,
conference papers, and book reviews were not included.
Research primarily included studies on U.S. populations due to changes in public health
implementation or needs across countries. For example, diminished resources strain frontline
health information workers at state and local government bodies. Those PIOs typically provide
directives during health events (Avery & Park, 2019). Therefore, independent communicators
like journalists or PR practitioners become more involved in facilitating health interventions.
Furthermore, the American population constitutes diverse groups, translating into multiple public
identities (Vardeman-Winter et al., 2013). Accordingly, public health behaviors can alter based
on social structure or affiliation.
Keywords and phrases like uses and gratification theory, public relations, mass or
traditional media, and vaccine or health messages were employed in the search. Of the various
academic sources pulled, 15% came from Health Communication, 15% from Journal of
Communication in Healthcare, 6% from Vaccine, 6% from Journal of Health Communication,
and 4% from Public Relations Review. The reference list of each article had been scanned as
well. Upon further discovery, the original work introducing uses and gratification theory in 1974
had also been retrieved.
Each source has been included based on its investigation of information-seeking
behaviors and their posited relationship to public health views or behaviors. When deciding
which articles were relevant to use, the following two questions were considered:
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EXAMINING THE INTERSECTION OF PUBLIC RELATIONS
RQ1: What traditional PR strategies do American health organizations employ to
communicate about vaccines to different U.S. publics?
RQ2: How did those PR strategies change when communicating about the COVID-19
vaccine to priority populations during the pandemic crisis?
Overview of Uses and Gratification Theory
Uses and gratification theory looks at the way media serves consumers. The uses and
gratification approach explores groups of need in tandem with the particular media sources that
satisfy those needs (Katz et al., 1973-1974). The theoretical framework emphasizes how people
interpret, form perceptions, and determine behaviors (Zhu et al., 2018).
Researchers have used the theory to explain the link between audience involvement and
mass media influence. Several studies apply the approach to how different audiences choose
mass media sources including newspapers, radio, television, and more recently the Internet
(Craig et al., 2013). The studies often analyze the media content. However, few studies focus on
the effects of a specific audience’s motivations on a channel (So, 2012).
Katz et al. (1973-1974) identified five elements of the uses and gratifications to consider
in the context of mass communication. The elements include (1) conceiving the audience as
active, (2) linking media choice to the audience member, (3) taking into account competing
sources of need satisfaction, (4) seeking data on mass media use that audience members supply
themselves and (5) suspending value judgments about the cultural significance of mass
communication (p. 510-11).
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EXAMINING THE INTERSECTION OF PUBLIC RELATIONS
Levy and Windahl (1984) expanded upon the role of an “active” audience by suggesting
that individuals voluntarily enter their communication settings. The authors conducted an
empirical study on audience involvement with television. They determined the amount of
engagement with an activity surrounding television broadcasts (e.g., eating, doing housework,
planning the evening to watch the news, comparing own ideas with reporters, etc.) correlates to
the strength of audience need. Accordingly, the type of activity influences the effects of media
exposure. In addition, different kinds of rewards exist based on contextual or relational factors.
So, members do not equally engage nor participate at the same times (Rubin, 2009).
Rubin (2009) divided the audience’s media use into ritualized or instrumental categories
to clarify the attitudes and expectations of the consumer who chooses to engage with the channel.
Ritualized demonstrates more habitual exposures related to diversion, whereas instrumental
reflects purposeful exposure to gain information at a specific point in time. Theaker (2011)
points out that audiences do not always engage with a channel to receive the intended message
by a communicator. Members of the audience act as involved communicators themselves rather
than merely passive receivers (Rubin, 2009).
Intersection of Uses and Gratification Theory and Health Communication
The uses and gratification approach investigates how people get information or
recommendations for their daily lives. For studies on health, it provides insights into the specific
goals of the audience such as reactive health decision-making, personal risk reduction or chronic
disease management (Lee & Hawkins, 2010). Health communication captures the psychological
and utilitarian motivations of the audience (Rubin, 2009).
Uses
Uses shape the motivations for seeking information. Media use is “chosen, goal-directed,
and motivated” (Walker, 2015, p. 860). Uses often reflect self-perception, which directly informs
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EXAMINING THE INTERSECTION OF PUBLIC RELATIONS
the media channels individuals prefer (Yoo, 2013). The most common motivations that influence
how people consume information from the media include environmental surveillance,
environmental diversion or entertainment and environmental interaction (Newsom et al., 2013).
For example, some people engage with the media out of personal necessity more than interest.
Zhu et al. (2018) found that the quality and interest of Alpha-1 Antitrypsin Deficiency (AATD)
information presented on the National Institutes of Health (NIH) website varied based on patient
experience. Generally, participants affected more severely by the disease perceived the
information quality and interest as lower. The research findings reinforced the idea that people
with rare diseases have difficulty becoming engaged. Individuals or groups tend to use the media
for surveillance when uncertainty becomes high (Zhu et al., 2018); however, the increased use of
particular media channels does not signal the amount of satisfaction with the information.
Alternatively, some people seek information to enjoy or maintain a positive sentiment.
The desire for enjoyment incentivizes audiences to personalize the media content more (So,
2012). For example, a study of health care professionals on social media determined that a
majority of respondents viewed social media websites as a personal
