Abstract A164: Rural and religious differences in online news outlet headlines about HPV and HPV vaccines in Utah
Authors: Warner Echo L. , Tovar Ida , Christini Kaila , Gubler Stephen , Slagle Becca , Smith Jennifer , Litchman Michelle , Birmingham Wendy , Kepka Deanna 
Published: September 2024

Abstract
Purpose: To evaluate the penetration of online HPV vaccine information in Utah, where HPV vaccination and completion rates are low, and uncover potential disparities by religiosity and rurality in the types of language used by news headlines in the social media ecosystem. Methods: We described the language used in local news outlets' headlines about HPV and HPV vaccines. We included headlines posted on Facebook from 23 news outlets within 6 counties (including high and low vaccination, rurality, and religiosity) from 2011-2023 to represent the public online discourse about HPV vaccination. We searched each news outlet’s Facebook page for eligible posts using 11 key terms (e.g., HPV, HPV vaccination) that were identified through literature review and refined with content experts, resulting in N=851 headlines. After removing duplicates, there were a total of n=531 unique headlines for analysis. Area-level (county) measures of rurality (2013 Rural and Urban Continuum Codes) and religiosity (Public Religion Research Institute 2020 Census) were coded for each post title based on the originating news outlet. We analyzed the language used in each headline. Differences in the valence of online discourse about HPV and HPV vaccination by rurality and religiosity were compared using summary statistics and t-tests. Linguistic analyses were conducted using Linguistic Inquiry Word Count and Stata 18. Results: Overall, urban areas were less religious than rural areas (28% unaffiliated in urban areas vs. 13-26% unaffiliated in rural areas, p&lt;0.001). There were more headlines about HPV and HPV vaccination from news outlets in urban than rural areas (69.7% vs. 30.3%). Nearly 70% of HPV and HPV vaccine headlines came from the least religious areas—counties whose religiously unaffiliated populations ranged from 28%-32%. News outlets differed in how they disseminated information about HPV and HPV vaccines by rurality and religiosity. On average, news outlets in urban areas used more positive language than in rural areas (mean 2.04 vs. 1.28 words, p&lt;0.01). Rural news outlets used more emotion-laden terms than those in urban areas (mean 1.2 vs. 0.6 words, p&lt;0.01) and negative emotion was more prevalent among rural than urban headlines (mean 0.73 vs. 0.42 words, p=0.02). These observations were mirrored for areas with higher religiously unaffiliated populations demonstrating titles with more positive words (mean 2.05 vs. 1.27, p&lt;0.01), less emotional words (mean 0.63 vs. 1.17 words, p&lt;0.01), and less negative language (mean 0.42 vs. 0.73 words, p=0.01) compared to headlines in areas with lower proportions of religiously unaffiliated, respectively. Conclusions: The penetration of HPV and HPV vaccine information in rural and religious areas is less positive, more emotionally charged, and uses more negative emotional language than in urban areas. This may, in part, perpetuate the low HPV vaccine uptake in these regions.
Citation Format: Echo L. Warner, Ida Tovar, Kaila Christini, Stephen Gubler, Becca Slagle, Jennifer Smith, Michelle Litchman, Wendy Birmingham, Deanna Kepka. Rural and religious differences in online news outlet headlines about HPV and HPV vaccines in Utah [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A164.