Revista Cultura Científica - web logo
Submit Your Research
  • Research Article

Mapping Fear and Hope in HPV Vaccine Communication on Sina Weibo: Topic Modeling and Content Analysis

Weiting Xu1, Jen-Sern Tham1, Wan Anita binti Wab Abas1, Jian Qin2, Yuan Long1
1Department of Communication, Faculty of Modern Languages and Communication, Universiti Putra Malaysia
2Department of Chinese Language and Literature, Faculty of Arts, Guangxi University of Foreign Language
DOI: https://doi.org/10.70517/revcc2624192
Published: 04/11/2026
: Weiting Xu, Jen-Sern Tham, Wan Anita binti Wab Abas, Jian Qin, Yuan Long. Mapping Fear and Hope in HPV Vaccine Communication on Sina Weibo: Topic Modeling and Content Analysis. Revista Cultura Científica, 2026 Issue 24. pg. 2390-2407.

Abstract

HPV vaccines became available in mainland China in 2016, yet concerns surrounding HPV vaccination have continued to feature prominently in public discourse. Against this background, this study examined how HPV and HPV vaccination are discussed on Sina Weibo and how threat- and efficacy-related message components are represented within this discourse. Drawing on the Extended Parallel Process Model (EPPM), this study analyzed 219,068 posts on Sina Weibo published between 2018 and 2024 using topic modeling and theory-guided content analysis. Topic modeling revealed a substantial increase in HPV-related discussions over the study period and identified five prominent themes: health behaviors, HPV vaccination, cervical cancer prevention, nine-valent HPV vaccine appointment scheduling, and HPV infection. Content analysis further revealed an imbalance between threat and efficacy components in fear-appeal messages. Efficacy information occurred more frequently than threat information, with self-efficacy appearing most frequently, followed by response efficacy, susceptibility, and severity. Spearman correlation analyses showed that severity and self-efficacy were positively associated with the number of user forwards, whereas susceptibility and response efficacy were not significantly associated with forwarding activity in the reported analysis. These findings extend the application of the EPPM to naturally occurring social media communication by demonstrating how threat and efficacy components are unevenly represented and differently associated with observable user engagement. The study also highlights the importance of designing HPV communication that balances information about health threats with clear and actionable efficacy information.

Keywords: HPV, HPV vaccine, Sina Weibo, topic modeling, content analysis

Abstract

HPV vaccines became available in mainland China in 2016, yet concerns surrounding HPV vaccination have continued to feature prominently in public discourse. Against this background, this study examined how HPV and HPV vaccination are discussed on Sina Weibo and how threat- and efficacy-related message components are represented within this discourse. Drawing on the Extended Parallel Process Model (EPPM), this study analyzed 219,068 posts on Sina Weibo published between 2018 and 2024 using topic modeling and theory-guided content analysis. Topic modeling revealed a substantial increase in HPV-related discussions over the study period and identified five prominent themes: health behaviors, HPV vaccination, cervical cancer prevention, nine-valent HPV vaccine appointment scheduling, and HPV infection. Content analysis further revealed an imbalance between threat and efficacy components in fear-appeal messages. Efficacy information occurred more frequently than threat information, with self-efficacy appearing most frequently, followed by response efficacy, susceptibility, and severity. Spearman correlation analyses showed that severity and self-efficacy were positively associated with the number of user forwards, whereas susceptibility and response efficacy were not significantly associated with forwarding activity in the reported analysis. These findings extend the application of the EPPM to naturally occurring social media communication by demonstrating how threat and efficacy components are unevenly represented and differently associated with observable user engagement. The study also highlights the importance of designing HPV communication that balances information about health threats with clear and actionable efficacy information.

Keywords: HPV, HPV vaccine, Sina Weibo, topic modeling, content analysis

References

  1. World Health Organization. “Human Papillomavirus and Cancer.” 5 March 2024. https://www.who.int/news-room/fact-sheets/detail/human-papilloma-virus-and-cancer.

  2. World Health Organization. Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem. Geneva: World Health Organization, 2020. https://www.who.int/publications/b/55745.

  3. National Health Commission of the People’s Republic of China. “Explanation of the Action Plan for Accelerating the Elimination of Cervical Cancer (2023–2030).” 20 January 2023. In Chinese. https://www.nhc.gov.cn/fys/c100077/202301/ab3a5117ff41482faeaa226f90f6ac2f.shtml.

  4. Hu, Shangying; Xu, Xiaoqian; Zhang, Yanyang; Liu, Yawen; Yang, Chunxia; Wang, Yueyun; Wang, Yan; Yu, Yanqin; Hong, Ying; Zhang, Xingxing; Bian, Rui; Cao, Xian; Xu, Lili; Zhao, Fanghui. “A nationwide post-marketing survey of knowledge, attitude and practice toward human papillomavirus vaccine in general population: Implications for vaccine roll-out in mainland China.” Vaccine, vol. 39, no. 1, 2021, pp. 35–44. https://doi.org/10.1016/j.vaccine.2020.11.029.

  5. Li, Yiwei; Guo, Yu; Lin, Hong. “Feminized Virus: A Content Analysis of Social Media’s Representation of HPV Vaccine.” Social Media + Society, vol. 8, no. 3, 2022, article 20563051221104232. https://doi.org/10.1177/20563051221104232.

  6. Zhou, Xuan; Gao, Hao; Wang, Jun. “A Computational Framework Analysis of Public Attitudes Toward Male Human Papillomavirus Infection and Its Vaccination in China: Based on Weibo Data.” Healthcare, vol. 13, no. 3, 2025, article 287. https://doi.org/10.3390/healthcare13030287.

  7. Ding, Zhijun; Yang, Haoyun; Zhou, Yingchen; Wang, Chiyu; Ma, Liyan; Ren, Kana; Hou, Zhiyuan. “Identifying barriers to human papillomavirus vaccination in China: a topic modelling analysis of social media (2018–2024).” BMJ Public Health, vol. 4, no. 1, 2026, article e003616. https://doi.org/10.1136/bmjph-2025-003616.

  8. Wang, You; Yang, Haoyun; Ding, Zhijun; Zhou, Xinyu; Zhou, Yingchen; Ma, Liyan; Lin, Leesa; Hou, Zhiyuan. “Deep learning analysis of trajectories and spatial variations in HPV vaccine discussions on Chinese Weibo.” Communications Medicine, vol. 6, no. 1, 2026, article 509. https://doi.org/10.1038/s43856-026-01720-5.

  9. Zhang, Lanyue; Zhang, Shouchuang; Liu, Siqi; Jian, Weiyan. “Human Papillomavirus Vaccination Policies and Discourse on Social Media.” JAMA Health Forum, vol. 7, no. 2, 2026, article e256425. https://doi.org/10.1001/jamahealthforum.2025.6425.

  10. Hu, Junyi; Whyke, Thomas William; Lopez-Mugica, Joaquin. “Investigating Media Coverage and Public Perceptions of the HPV Vaccine in China – A Content Analysis of Weibo Posts.” Sexuality & Culture, vol. 27, no. 2, 2023, pp. 363–388. https://doi.org/10.1007/s12119-022-10017-3.

  11. Jiang, Shaohai; Wang, Pianpian; Liu, Piper Liping; Ngien, Annabel; Wu, Xingtong. “Social Media Communication about HPV Vaccine in China: A Study Using Topic Modeling and Survey.” Health Communication, vol. 38, no. 5, 2023, pp. 935–946. https://doi.org/10.1080/10410236.2021.1983338.

  12. Li, Danyang; Tao, Yuan. “Not just female narratives: a discourse analysis of HPV vaccination coverage on Chinese social media.” Feminist Media Studies, 2026, pp. 1–16. https://doi.org/10.1080/14680777.2026.2680431.

  13. Chen, Liang; Yang, Xiaodong; Huang, Xiaocong. “Promoting HPV vaccination on social media: interactive effects of threat, efficacy and social cues.” Human Vaccines & Immunotherapeutics, vol. 17, no. 11, 2021, pp. 4442–4456. https://doi.org/10.1080/21645515.2021.1975449.

  14. Limbu, Yam B.; Huhmann, Bruce A.. “Message Effectiveness of Fear Appeals in Vaccination Communication Campaigns: A Systematic Review.” Vaccines, vol. 12, no. 6, 2024, article 653. https://doi.org/10.3390/vaccines12060653.

  15. Reno, Jenna E.; Dempsey, Amanda F.. “Testing Messages on Facebook to Promote Use of an HPV Educational Web-Intervention.” Frontiers in Digital Health, vol. 3, 2021, article 648555. https://doi.org/10.3389/fdgth.2021.648555.

  16. Moorhead, S Anne; Hazlett, Diane E; Harrison, Laura; Carroll, Jennifer K; Irwin, Anthea; Hoving, Ciska. “A New Dimension of Health Care: Systematic Review of the Uses, Benefits, and Limitations of Social Media for Health Communication.” Journal of Medical Internet Research, vol. 15, no. 4, 2013, article e85. https://doi.org/10.2196/jmir.1933.

  17. Long, Yuan; Tham, Jen-Sern; Amin Nordin, Syafinaz. “Influence of User Comments on Health Communication: A Systematic Review.” Asian Journal of Applied Communication, vol. 14, no. 2, 2025. https://doi.org/10.47836/ajac.14.02.01. https://ajac-fbmk.upm.edu.my/regular-issues/vol-14-no-2-december-2025/ajac-01-dec2025.

  18. Wang, Yuxi; McKee, Martin; Torbica, Aleksandra; Stuckler, David. “Systematic Literature Review on the Spread of Health-related Misinformation on Social Media.” Social Science & Medicine, vol. 240, 2019, article 112552. https://doi.org/10.1016/j.socscimed.2019.112552.

  19. Habel, Melissa A.; Liddon, Nicole; Stryker, Jo E.. “The HPV Vaccine: A Content Analysis of Online News Stories.” Journal of Women’s Health, vol. 18, no. 3, 2009, pp. 401–407. https://doi.org/10.1089/jwh.2008.0920.

  20. Ortiz, Rebecca R.; Smith, Andrea; Coyne-Beasley, Tamera. “A systematic literature review to examine the potential for social media to impact HPV vaccine uptake and awareness, knowledge, and attitudes about HPV and HPV vaccination.” Human Vaccines & Immunotherapeutics, vol. 15, no. 7-8, 2019, pp. 1465–1475. https://doi.org/10.1080/21645515.2019.1581543.

  21. Thackeray, Rosemary; Neiger, Brad L; Smith, Amanda K; Van Wagenen, Sarah B. “Adoption and use of social media among public health departments.” BMC Public Health, vol. 12, no. 1, 2012, article 242. https://doi.org/10.1186/1471-2458-12-242.

  22. Agergaard, Torben E.; Smith, Màiri E.; Gammelby, Ane Kathrine; Tørring, Marie Louise; Nielsen, Kristian H.. “Complexity and controversy in media coverage of Human papillomavirus (HPV) vaccination: A qualitative content analysis of news coverage in Denmark 2008–2018.” Frontiers in Communication, vol. 8, 2023, article 1032460. https://doi.org/10.3389/fcomm.2023.1032460.

  23. Pen a, M. A.; B ban, A.. “Mass media coverage of HPV vaccination in Romania: a content analysis.” Health Education Research, vol. 29, no. 6, 2014, pp. 977–992. https://doi.org/10.1093/her/cyu027.

  24. Tsuda, Kenji; Yamamoto, Kana; Leppold, Claire; Tanimoto, Tetsuya; Kusumi, Eiji; Komatsu, Tsunehiko; Kami, Masahiro. “Trends of Media Coverage on Human Papillomavirus Vaccination in Japanese Newspapers.” Clinical Infectious Diseases, vol. 63, no. 12, 2016, pp. 1634–1638. https://doi.org/10.1093/cid/ciw647.

  25. Okuhara, Tsuyoshi; Ishikawa, Hirono; Okada, Masafumi; Kato, Mio; Kiuchi, Takahiro. “Newspaper coverage before and after the HPV vaccination crisis began in Japan: a text mining analysis.” BMC Public Health, vol. 19, no. 1, 2019, article 770. https://doi.org/10.1186/s12889-019-7097-2.

  26. Walker, Kimberly K; Owens, Heather; Zimet, Gregory. ““We fear the unknown”: Emergence, route and transfer of hesitancy and misinformation among HPV vaccine accepting mothers.” Preventive Medicine Reports, vol. 20, 2020, article 101240. https://doi.org/10.1016/j.pmedr.2020.101240.

  27. Nan, Xiaoli; Daily, Kelly. “Biased Assimilation and Need for Closure: Examining the Effects of Mixed Blogs on Vaccine-Related Beliefs.” Journal of Health Communication, vol. 20, no. 4, 2015, pp. 462–471. https://doi.org/10.1080/10810730.2014.989343.

  28. Massey, Philip M; Kearney, Matthew D; Hauer, Michael K; Selvan, Preethi; Koku, Emmanuel; Leader, Amy E. “Dimensions of Misinformation About the HPV Vaccine on Instagram: Content and Network Analysis of Social Media Characteristics.” Journal of Medical Internet Research, vol. 22, no. 12, 2020, article e21451. https://doi.org/10.2196/21451.

  29. Boatman, Dannell; Jarrett, Zachary; Starkey, Abby; Conn, Mary Ellen; Kennedy-Rea, Stephenie. “HPV vaccine misinformation on social media: A multi-method qualitative analysis of comments across three platforms.” PEC Innovation, vol. 5, 2024, article 100329. https://doi.org/10.1016/j.pecinn.2024.100329.

  30. Rao, Qingmao; Zhang, Zuyue; Lv, Yalan; Zhao, Yong; Bai, Li; Hou, Xiaorong. “Factors Associated With Influential Health-Promoting Messages on Social Media: Content Analysis of Sina Weibo.” JMIR Medical Informatics, vol. 8, no. 10, 2020, article e20558. https://doi.org/10.2196/20558.

  31. Liu, Xinchuan; Lu, Jia; Wang, Haiyan. “When Health Information Meets Social Media: Exploring Virality on Sina Weibo.” Health Communication, vol. 32, no. 10, 2017, pp. 1252–1260. https://doi.org/10.1080/10410236.2016.1217454.

  32. Han, Gang (Kevin); Wang, Wen. “Mapping user relationships for health information diffusion on microblogging in China: A social network analysis of Sina Weibo.” Asian Journal of Communication, vol. 25, no. 1, 2015, pp. 65–83. https://doi.org/10.1080/01292986.2014.989239.

  33. Li, Wenbo; Nowak, Glen; Jin, Yan; Cacciatore, Michael. “Inadequate and Incomplete: Chinese Newspapers’ Coverage of the First Licensed Human Papillomavirus (HPV) Vaccine in China.” Journal of Health Communication, vol. 23, no. 6, 2018, pp. 581–590. https://doi.org/10.1080/10810730.2018.1493060.

  34. Li, Jinhui; Zheng, Han. “Coverage of HPV-Related Information on Chinese Social Media: a Content Analysis of Articles in Zhihu.” Human Vaccines & Immunotherapeutics, vol. 16, no. 10, 2020, pp. 2548–2554. https://doi.org/10.1080/21645515.2020.1729028.

  35. Rogers, Ronald W.; Deckner, C. William. “Effects of fear appeals and physiological arousal upon emotion, attitudes, and cigarette smoking.” Journal of Personality and Social Psychology, vol. 32, no. 2, 1975, pp. 222–230. https://doi.org/10.1037/0022-3514.32.2.222.

  36. Bassett-Gunter, Rebecca L.; Latimer-Cheung, Amy E.; Martin Ginis, Kathleen A.; Castelhano, Monica. “I Spy With My Little Eye: Cognitive Processing of Framed Physical Activity Messages.” Journal of Health Communication, vol. 19, no. 6, 2014, pp. 676–691. https://doi.org/10.1080/10810730.2013.837553.

  37. Carcioppolo, Nick; Jensen, Jakob D.; Wilson, Steven R.; Collins, W. Bart; Carrion, Melissa; Linnemeier, Georgiann. “Examining HPV Threat-to-Efficacy Ratios in the Extended Parallel Process Model.” Health Communication, vol. 28, no. 1, 2013, pp. 20–28. https://doi.org/10.1080/10410236.2012.719478.

  38. Chen, Liang; Yang, Xiaodong. “Using EPPM to Evaluate the Effectiveness of Fear Appeal Messages Across Different Media Outlets to Increase the Intention of Breast Self-Examination Among Chinese Women.” Health Communication, vol. 34, no. 11, 2019, pp. 1369–1376. https://doi.org/10.1080/10410236.2018.1493416.

  39. Hatchell, Alexandra C.; Bassett-Gunter, Rebecca L.; Clarke, Marie; Kimura, Stacey; Latimer-Cheung, Amy E.. “Messages for men: The efficacy of EPPM-based messages targeting men’s physical activity.” Health Psychology, vol. 32, no. 1, 2013, pp. 24–32. https://doi.org/10.1037/a0030108.

  40. Jin, Shan Shan; Bu, Kai; Chen, Fang Fang; Xu, Hui Fang; Li, Yi; Zhao, Dong Hui; Xu, Fang; Li, Jing Yan; Han, Meng Jie; Wang, Ning; Wang, Lu. “Correlates of Condom-use Self-efficacy on the EPPM-based Integrated Model among Chinese College Students.” Biomedical and Environmental Sciences, vol. 30, no. 2, 2017, pp. 97–105. https://doi.org/10.3967/bes2017.013.

  41. Krieger, Janice L.; Sarge, Melanie A.. “A Serial Mediation Model of Message Framing on Intentions to Receive the Human Papillomavirus (HPV) Vaccine: Revisiting the Role of Threat and Efficacy Perceptions.” Health Communication, vol. 28, no. 1, 2013, pp. 5–19. https://doi.org/10.1080/10410236.2012.734914.

  42. Witte, Kim. “Putting the fear back into fear appeals: The extended parallel process model.” Communication Monographs, vol. 59, no. 4, 1992, pp. 329–349. https://doi.org/10.1080/03637759209376276.

  43. Witte, Kim. “Fear control and danger control: A test of the extended parallel process model (EPPM).” Communication Monographs, vol. 61, no. 2, 1994, pp. 113–134. https://doi.org/10.1080/03637759409376328.

  44. van Swol, Lyn M.; Dai, Ika; Shaw, Bret; Dehnert, Gavin; Hutchins, Rachel A.. “Threat and Efficacy in Persuasive Messages About PFAS in Public Drinking Water.” Science Communication, 2026, article 10755470261422165. https://doi.org/10.1177/10755470261422165.

  45. Yoon, Hyejung; You, Myoungsoon; Shon, Changwoo. “An application of the extended parallel process model to protective behaviors against COVID-19 in South Korea.” PLOS ONE, vol. 17, no. 3, 2022, article e0261132. https://doi.org/10.1371/journal.pone.0261132.

  46. Shi, Jingyuan (Jolie); Smith, Sandi W.. “The effects of fear appeal message repetition on perceived threat, perceived efficacy, and behavioral intention in the extended parallel process model.” Health Communication, vol. 31, no. 3, 2016, pp. 275–286. https://doi.org/10.1080/10410236.2014.948145.

  47. WITTE, KIM. “Predicting Risk Behaviors: Development and Validation of a Diagnostic Scale.” Journal of Health Communication, vol. 1, no. 4, 1996, pp. 317–342. https://doi.org/10.1080/108107396127988.

  48. McMahan, Shari; Witte, Kim; Meyer, Jon’a. “The Perception of Risk Messages Regarding Electromagnetic Fields: Extending the Extended Parallel Process Model to an Unknown Risk.” Health Communication, vol. 10, no. 3, 1998, pp. 247–259. https://doi.org/10.1207/s15327027hc1003_4.

  49. Sheeran, Paschal; Harris, Peter R.; Epton, Tracy. “Does heightening risk appraisals change people’s intentions and behavior? A meta-analysis of experimental studies.” Psychological Bulletin, vol. 140, no. 2, 2014, pp. 511–543. https://doi.org/10.1037/a0033065.

  50. Witte, Kim; Allen, Mike. “A Meta-Analysis of Fear Appeals: Implications for Effective Public Health Campaigns.” Health Education & Behavior, vol. 27, no. 5, 2000, pp. 591–615. https://doi.org/10.1177/109019810002700506.

  51. Zhang Meadows, Cui. “The Effects of Fear Appeals and Message Format on Promoting Skin Cancer Prevention Behaviors among College Students.” Societies, vol. 10, no. 1, 2020, article 21. https://doi.org/10.3390/soc10010021.

  52. Sarrina Li, Shu-Chu; Huang, Lin-Mei Stella. “Fear appeals, information processing, and behavioral intentions toward climate change.” Asian Journal of Communication, vol. 30, no. 3-4, 2020, pp. 242–260. https://doi.org/10.1080/01292986.2020.1784967.

  53. So, Jiyeon. “A Further Extension of the Extended Parallel Process Model (E-EPPM): Implications of Cognitive Appraisal Theory of Emotion and Dispositional Coping Style.” Health Communication, vol. 28, no. 1, 2013, pp. 72–83. https://doi.org/10.1080/10410236.2012.708633.

  54. Popova, Lucy. “The Extended Parallel Process Model: Illuminating the Gaps in Research.” Health Education & Behavior, vol. 39, no. 4, 2012, pp. 455–473. https://doi.org/10.1177/1090198111418108.

  55. Nabi, Robin L.; Myrick, Jessica Gall. “Uplifting Fear Appeals: Considering the Role of Hope in Fear-Based Persuasive Messages.” Health Communication, vol. 34, no. 4, 2019, pp. 463–474. https://doi.org/10.1080/10410236.2017.1422847.

  56. Kim, Hanyoung; Han, Jeong Yeob; So, Jiyeon; Seo, Youngji. “An Investigation of Cognitive Processing of Fear Appeal Messages Promoting HPV Vaccination: Predictors and Outcomes of Magnitude and Valence of Cognitive Responses.” Journal of Health Communication, vol. 25, no. 11, 2020, pp. 885–894. https://doi.org/10.1080/10810730.2020.1842566.

  57. Lu, Linqi; Liu, Jiawei; Kim, Sang Jung; Tao, Ran; Shah, Dhavan V.; McLeod, Douglas M.. “The Effects of Vaccine Efficacy Information on Vaccination Intentions Through Perceived Response Efficacy and Hope.” Journal of Health Communication, vol. 28, no. 2, 2023, pp. 121–129. https://doi.org/10.1080/10810730.2023.2186545.

  58. Roberto, Anthony J.; Mongeau, Paul A.; Liu, Yanqin; Hashi, Emi C.. ““Fear the Flu, Not the Flu Shot”: A Test of the Extended Parallel Process Model.” Journal of Health Communication, vol. 24, no. 11, 2019, pp. 829–836. https://doi.org/10.1080/10810730.2019.1673520.

  59. Lu, Hang; Yuan, Shupei. “Exploring the Sequencing Effects of Fear-Hope Appeals on Promoting MMR Vaccination.” Health Communication, vol. 38, no. 10, 2023, pp. 2132–2140. https://doi.org/10.1080/10410236.2022.2054229.

  60. Nabi, Robin L.; Prestin, Abby. “Unrealistic Hope and Unnecessary Fear: Exploring How Sensationalistic News Stories Influence Health Behavior Motivation.” Health Communication, vol. 31, no. 9, 2016, pp. 1115–1126. https://doi.org/10.1080/10410236.2015.1045237.

  61. Heo, Ruth J.; Miller, Serena; Takahashi, Bruno; Corttrell, Jonus. “A content analysis of EPPM’s threat and efficacy information in environmental news: The impact of a community of practice and topic.” Newspaper Research Journal, vol. 45, no. 3, 2024, pp. 332–350. https://doi.org/10.1177/07395329241248756.

  62. Kline, Kimberly Nicole; Mattson, Marifran. “Breast Self-Examination Pamphlets: A Content Analysis Grounded in Fear Appeal Research.” Health Communication, vol. 12, no. 1, 2000, pp. 1–21. https://doi.org/10.1207/s15327027hc1201_01.

  63. LaVoie, Nicole R.; Quick, Brian L.. “What Is the Truth? An Application of the Extended Parallel Process Model to Televised Truth® Ads.” Health Communication, vol. 28, no. 1, 2013, pp. 53–62. https://doi.org/10.1080/10410236.2012.728467.

  64. Ng, Yee Man Margaret. “A Cross-National Study of Fear Appeal Messages in YouTube Trending Videos About COVID-19.” American Behavioral Scientist, vol. 69, no. 9, 2025, pp. 1092–1112. https://doi.org/10.1177/00027642231155363.

  65. Goodall, Catherine; Sabo, Jason; Cline, Rebecca; Egbert, Nichole. “Threat, Efficacy, and Uncertainty in the First 5 Months of National Print and Electronic News Coverage of the H1N1 Virus.” Journal of Health Communication, vol. 17, no. 3, 2012, pp. 338–355. https://doi.org/10.1080/10810730.2011.626499.

  66. Turner, Monique Mitchell; Boudewyns, Vanessa; Kirby-Straker, Rowie; Telfer, Jana. “A double dose of fear: A theory-based content analysis of news articles surrounding the 2006 cough syrup contamination crisis in Panama.” Risk Management, vol. 15, no. 2, 2013, pp. 79–99. https://doi.org/10.1057/rm.2012.13.

  67. Hase, Valerie; Engelke, Katherine M.. “Emotions in Crisis Coverage: How UK News Media Used Fear Appeals to Report on the Coronavirus Crisis.” Journalism and Media, vol. 3, no. 4, 2022, pp. 633–649. https://doi.org/10.3390/journalmedia3040042.

  68. Peng, Lixia; Tai, Zixue; Liu, Xiaolong. “Health anxiety and collective sense-making in the Chinese social media sphere: a topic modeling assessment of Weibo chatters.” BMC Public Health, vol. 26, no. 1, 2026, article 2817. https://doi.org/10.1186/s12889-026-28505-8.

  69. Yao, Le; Ngai, Cindy Sing Bik; Singh, Rita Gill; Chen, Fangfang. “Social Media Users’ Engagement with Fear Appeal Elements in Government’s Health Crisis Communication via State-Owned Media.” Journal of Health Communication, vol. 29, no. 8, 2024, pp. 524–537. https://doi.org/10.1080/10810730.2024.2378338.

  70. Lee, Dokyun; Hosanagar, Kartik; Nair, Harikesh S.. “Advertising Content and Consumer Engagement on Social Media: Evidence from Facebook.” Management Science, vol. 64, no. 11, 2018, pp. 5105–5131. https://doi.org/10.1287/mnsc.2017.2902.

  71. Alhassan, Fatimah Mohammed; AlDossary, Sharifah Abdullah. “The Saudi Ministry of Health’s Twitter Communication Strategies and Public Engagement During the COVID-19 Pandemic: Content Analysis Study.” JMIR Public Health and Surveillance, vol. 7, no. 7, 2021, article e27942. https://doi.org/10.2196/27942.

  72. Guo, Yanan; Liu, Jida; Lian, Chenxi. “Promote citizen engagement with warnings ― an empirical examination of government social media accounts during public health crises.” BMC Public Health, vol. 25, no. 1, 2025, article 1508. https://doi.org/10.1186/s12889-025-22760-x.

  73. Long, Yuan; Tham, Jen-Sern; Amin Nordin, Syafinaz. “Effect of Online Comments on HPV Vaccination Intentions: The Role of Valence, Argument Quality, and Self-Efficacy.” Asian Journal for Public Opinion Research, vol. 14, no. 1, 2026, pp. 24–45. https://doi.org/10.15206/ajpor.2026.14.1.24.

  74. Kite, James; Chan, Lilian; MacKay, Kathryn; Corbett, Lucy; Reyes-Marcelino, Gillian; Nguyen, Binh; Bellew, William; Freeman, Becky. “A Model of Social Media Effects in Public Health Communication Campaigns: Systematic Review.” Journal of Medical Internet Research, vol. 25, 2023, article e46345. https://doi.org/10.2196/46345.

  75. Weibo Corporation. “Weibo Reports Fourth Quarter and Fiscal Year 2021 Unaudited Financial Results.” 3 March 2022. https://www.prnewswire.com/news-releases/weibo-reports-fourth-quarter-and-fiscal-year-2021-unaudited-financial-results-301494863.html.

  76. Maier, Daniel; Waldherr, A.; Miltner, P.; Wiedemann, G.; Niekler, A.; Keinert, A.; Pfetsch, B.; Heyer, G.; Reber, U.; Häussler, T.; Schmid-Petri, H.; Adam, S.. “Applying LDA Topic Modeling in Communication Research: Toward a Valid and Reliable Methodology.” Communication Methods and Measures, vol. 12, no. 2-3, 2018, pp. 93–118. https://doi.org/10.1080/19312458.2018.1430754.

  77. Altman, Douglas G. Practical Statistics for Medical Research. London: Chapman & Hall, 1991.

  78. Chen, Liang; Wang, Xiaohui; Peng, Tai-Quan. “Nature and Diffusion of Gynecologic Cancer–Related Misinformation on Social Media: Analysis of Tweets.” Journal of Medical Internet Research, vol. 20, no. 10, 2018, article e11515. https://doi.org/10.2196/11515.

  79. Metaxas, Panagiotis; Mustafaraj, Eni; Wong, Kily; Zeng, Laura; O’Keefe, Megan; Finn, Samantha. “What Do Retweets Indicate? Results from User Survey and Meta-Review of Research.” Proceedings of the International AAAI Conference on Web and Social Media, vol. 9, no. 1, 2021, pp. 658–661. https://doi.org/10.1609/icwsm.v9i1.14661.

  80. National Health Commission of the People’s Republic of China and nine other national bodies. “Notice on Issuing the Action Plan for Accelerating the Elimination of Cervical Cancer (2023–2030).” Issued 5 January 2023; posted 20 January 2023. In Chinese. https://www.nhc.gov.cn/fys/c100078/202301/001debf5e15f4da99d03aac3a803b2de.shtml.

  81. Wu, Manli; Wu, Tailai; Pei, Yiming. “What Drives Health Information Exchange on Social Media? Social Media Affordances and Social Support Perspectives.” Health Communication, vol. 39, no. 13, 2024, pp. 3365–3379. https://doi.org/10.1080/10410236.2024.2321408.

  82. Wong, Li Ping; Wong, Pooi-Fong; Megat Hashim, Megat Mohamad Amirul Amzar; Han, Liyuan; Lin, Yulan; Hu, Zhijian; Zhao, Qinjian; Zimet, Gregory D.. “Multidimensional social and cultural norms influencing HPV vaccine hesitancy in Asia.” Human Vaccines & Immunotherapeutics, vol. 16, no. 7, 2020, pp. 1611–1622. https://doi.org/10.1080/21645515.2020.1756670.

  83. Yi, Youqin; Xiu, Shixin; Shi, Naiyang; Huang, Yue; Zhang, Shihan; Wang, Qiang; Yang, Liuqing; Cui, Tingting; Wang, Yuning; Shen, Yuan; Jin, Hui. “Perceptions and acceptability of HPV vaccination among parents of female adolescents 9–14 in China: A cross-sectional survey based on the theory of planned behavior.” Human Vaccines & Immunotherapeutics, vol. 19, no. 2, 2023, article 2225994. https://doi.org/10.1080/21645515.2023.2225994.

  84. Yip, Yan Yee; Makmor-Bakry, Mohd; Chong, Wei Wen. “Elements Influencing User Engagement in Social Media Posts on Lifestyle Risk Factors: Systematic Review.” Journal of Medical Internet Research, vol. 26, 2024, article e59742. https://doi.org/10.2196/59742.

Weiting Xu
Department of Communication, Faculty of Modern Languages and Communication, Universiti Putra Malaysia
Jen-Sern Tham
Department of Communication, Faculty of Modern Languages and Communication, Universiti Putra Malaysia
jstham@upm.edu.my
Wan Anita binti Wab Abas
Department of Communication, Faculty of Modern Languages and Communication, Universiti Putra Malaysia
Jian Qin
Department of Chinese Language and Literature, Faculty of Arts, Guangxi University of Foreign Language
Yuan Long
Department of Communication, Faculty of Modern Languages and Communication, Universiti Putra Malaysia

How to cite:

Weiting Xu, Jen-Sern Tham, Wan Anita binti Wab Abas, Jian Qin, Yuan Long. Mapping Fear and Hope in HPV Vaccine Communication on Sina Weibo: Topic Modeling and Content Analysis. Revista Cultura Científica, 2026 Issue 24. pg. 2390-2407.

Publication History

  • Received: 27/08/2026
  • Accepted: 19/10/2026
  • Published: 04/11/2026
Copyright © 2026, Weiting Xu, Jen-Sern Tham, Wan Anita binti Wab Abas, Jian Qin, Yuan Long. Published by Revista Cultura Científica. This article is published as open access under the Creative Commons Attribution 4.0 International (CC BY 4.0) license (http://creativecommons.org/licenses/by/4.0/).

Browse Advance Search