Author ORCID Identifier


Defense Date


Document Type


Degree Name

Doctor of Philosophy


Social and Behavioral Health

First Advisor

Kellie Carlyle, PhD

Second Advisor

Jessica LaRose, PhD

Third Advisor

Marcus Messner, PhD

Fourth Advisor

Paul Perrin, PhD

Fifth Advisor

Mark Ryan, MD


The Zika virus is associated with the devastating birth defect microcephaly, and while a vaccine was not yet available in early-2017, several were under development. It is imperative to identify effective communication strategies to promote uptake of a new vaccine, particularly among women of reproductive age. Moreover, though the Zika outbreak has received much social media attention, little is known about these conversations on Instagram. The purpose of this dissertation, therefore, was to understand current Zika-focused communication on Instagram and to inform effective communication strategies to promote future Zika vaccine uptake intent.

The study aims were: (1) explore Zika conversations on Instagram; (2) determine effective message characteristics to increase Zika vaccine uptake intent; and (3) explore salient demographic, healthcare, and psychosocial factors related to Zika vaccine uptake intent.

A content analysis of 1,000 Zika-focused Instagram posts, found that these messages primarily focus on perceived threat constructs, yet they elicited little engagement. In addition, 10% of all Instagram posts mentioned conspiracy theories, and these messages elicited high engagement.

A 2x2 online experiment tested the effect of message framing and visual type on Zika vaccine uptake intent. The 339 participants – all women of reproductive age – each were exposed to one of four messages (gain vs. loss-framed, and infographic vs. photo). There was no interaction effect of framing and visual type (p=.116), nor main effect of either framing (p=.185) or visual type (p=.724) on vaccine uptake intent. When testing the effect of these variables on those known to be predictors of behavioral intent, gain-framed messages were associated with higher subjective norms, perceived benefits, and self-efficacy.

Data from the same online survey was used to examine whether demographics, healthcare-related variables, and psychosocial variables predict Zika vaccine uptake intent. Attitude (p<.001), subjective norms (p=.002), perceived benefits (p=.001), self-efficacy (p=.031), perceived susceptibility (p=.030), and cues to action (p=.020) were predictive of higher Zika vaccine uptake intent, as was being African-American (p=.042).

In summary, messages promoting the Zika vaccine should be designed to complement the high perceived threat of Zika while activating positive social norms and perceived benefits in order to allow the public to respond efficaciously.


If possible, please list my full name as Jeanine Patricia Drost Guidry, my legal name


© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission