{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:25:49Z","timestamp":1790234749892,"version":"4.1.0"},"reference-count":26,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>As communication technology advances and the digital divide grows, a deeper understanding of the influence of different information sources on vaccine uptake by generations can inform targeted public health interventions in times of future crisis. While the COVID-19 pandemic highlighted the role of media sources on the decision to receive vaccines, no studies have focused on the impact of the type and number of information sources in a population-based sample in California.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In this study, we examined associations between Californians\u2019 self-reported most relied upon COVID-19 information sources, categorized by type and measured as a count, and their COVID-19 vaccination status using data collected from the 2022 California Health Interview Survey. To address differences in information preferences and vaccine uptake by age, we also tested for potential effect modification of the relationship between relied upon COVID-19 information sources and vaccination status by generational membership (eg, Generation Z, millennials, Generation X, baby boomers, and Silent Generation).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a secondary analysis of cross-sectional data from the 2022 California Health Interview Survey. Vaccine status (any or none) was modeled as a function of information sources (or count) controlling for important sociodemographic and health confounding variables. Interaction terms of information sources (or count) by generational status were added to the models to test effect modification, and if significant, the models were stratified by generation. All analysis was survey-weighted to account for the complex survey sampling design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to relying on traditional news media for COVID-19 information, relying on word of mouth (odds ratio [OR] 0.6), social media (OR 0.62), and doctors (OR 0.41) for COVID-19 information was associated with lower odds of being vaccinated for COVID-19. A dose-response relationship was identified, with each additional information source associated with 9% higher odds of being vaccinated for COVID-19. In stratified models, social media, compared to traditional news media, was associated with lower odds of vaccination for Generation X, baby boomers, and the Silent Generation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Health information preferences, especially for traditional news media, are associated with COVID-19 vaccine uptake, and the information sources differ by generation. These findings provide information for stakeholders interested in vaccine hesitancy, health informatics, messaging strategies, health literacy, and future health information outreach programs during epidemics or pandemics. Dissemination of public health information should include multiple information sources to reach all individual preferences across different generations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/85904","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T14:10:07Z","timestamp":1766412607000},"page":"e85904-e85904","source":"Crossref","is-referenced-by-count":1,"title":["COVID-19 Information Sources and Vaccination Status Among Californian Adults by Generation Using the 2022 California Health Interview Survey: Cross-Sectional Study"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3824-9088","authenticated-orcid":false,"given":"Julia Forest","family":"Zabala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9074-6355","authenticated-orcid":false,"given":"Melissa","family":"Sablik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6483-0383","authenticated-orcid":false,"given":"Gina R","family":"Finical","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6707-6611","authenticated-orcid":false,"given":"Victoria F","family":"Keeton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6528-0686","authenticated-orcid":false,"given":"Janice F","family":"Bell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"issue":"8","key":"R1","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1016\/j.medmal.2020.01.010","article-title":"Influence of information sources on vaccine hesitancy and practices","volume":"50","author":"Charron","journal-title":"Med Mal Infect"},{"issue":"3","key":"R2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.7255","article-title":"Coronavirus goes viral: quantifying the COVID-19 misinformation epidemic on Twitter","volume":"12","author":"Kouzy","journal-title":"Cureus"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-020-01556-3","article-title":"Coronavirus: the spread of misinformation","volume":"18","author":"Mian","journal-title":"BMC Med"},{"issue":"4","key":"R4","doi-asserted-by":"publisher","DOI":"10.2196\/21071","article-title":"Trends and predictors of COVID-19 information sources and their relationship with knowledge and beliefs related to the pandemic: nationwide cross-sectional study","volume":"6","author":"Ali","journal-title":"JMIR Public Health Surveill"},{"issue":"2","key":"R5","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1080\/21645515.2017.1264733","article-title":"Information sources and knowledge on vaccination in a population from southern Italy: the ESCULAPIO project","volume":"13","author":"Tabacchi","journal-title":"Hum Vaccin Immunother"},{"issue":"1","key":"R6","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-21-00237","article-title":"Role of information sources in vaccination uptake: insights from a cross-sectional household survey in Sierra Leone, 2019","volume":"10","author":"Kulkarni","journal-title":"Glob Health Sci Pract"},{"issue":"19","key":"R7","doi-asserted-by":"publisher","first-page":"3003","DOI":"10.1016\/j.vaccine.2012.01.079","article-title":"Evaluating associations between sources of information, knowledge of the human papillomavirus, and human papillomavirus vaccine uptake for adult women in California","volume":"30","author":"Almeida","journal-title":"Vaccine (Auckl)"},{"issue":"8","key":"R8","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1016\/j.jamda.2023.05.024","article-title":"Association of sources of COVID-19 information with vaccine uptake, preventive behaviors, and perceived severity of COVID-19","volume":"24","author":"Kim","journal-title":"J Am Med Dir Assoc"},{"issue":"3","key":"R9","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1177\/00333549231186603","article-title":"Identification of spatial clusters of undervaccination patterns among children aged <24 months using Immunization Information System Data, Montana, 2015-2019","volume":"139","author":"Newcomer","journal-title":"Public Health Rep"},{"issue":"36","key":"R10","doi-asserted-by":"publisher","first-page":"5313","DOI":"10.1016\/j.vaccine.2023.07.004","article-title":"Let\u2019s talk about COVID-19 vaccination: relevance of conversations about COVID-19 vaccination and information sources on vaccination intention in Switzerland","volume":"41","author":"Wagner","journal-title":"Vaccine"},{"key":"R11","unstructured":"Ten threats to global health in 2019. 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