The outbreak of the COVID-19 pandemic found a fertile ground for the spread of online misinformation, with emphasis on social media. Avoiding misinformation spread requires rapid, engaging, and effective science communication in a clear, easy-to-understand, attractive, and entertaining format that can be readily shared online. Comics fulfill these characteristics, being a promising tool to fight misinformation on social media. The goals of this study were: 1) Develop a novel narrative comic strip to promote recognition of misinformation about the COVID-19 vaccine among adult social media users (ages 18-65) based in the United States, drawing on the existing research on the Health Belief Model and Theory of Planned Behavior; 2.) Compare the comic strip evaluation and capacity to influence misinformation identification to those of an educational text about COVID-19 vaccination. 3a) Evaluate differences in the key outcomes (misinformation identification, and attractiveness, trust, perceived usefulness, willingness to share, and acceptance of each educational tool) across participants with varying demographic characteristics, health literacy levels, COVID-19 vaccination history, and demographic characteristics. 3b) Across the entire sample, evaluate the correlation between these constructs and health literacy, digital health literacy, vaccine attitudes, trust in science and health authorities, and social media use. Participants (N = 285) were recruited via social media advertisements and randomly assigned to the comic strip group (CS) (N = 92), educational text (TX) (N = 96), or a control 4 group (CL) (N = 97), which had not read any educational material. An online survey accessed the main outcomes (misinformation about the COVID-19 vaccines, evaluation of the educational tool (attractiveness, trust, perceived usefulness, willingness to share, and acceptance of the educational material). Participants also answered demographics questionnaires, COVID-19 vaccine concerns scale, and questionnaires on Health literacy, eHealth literacy, social media use, trust in health authorities and scientists, and COVID-19 vaccination history. Group CS answered questions regarding transportation into the narrative. There were no differences in misinformation identification between groups, possibly explained by a low sensibility of the misinformation identification instrument, timing of the data collection, and sensitiveness of the vaccination topic, subject to accrued attitudes, such as believing in misinformation. Participants with lower health literacy in group TX scored less on the misinformation identification questionnaire than those with higher literacy, which was not observed in the CS group, indicating that the comic strip may benefit better individuals with low health literacy. Vaccine hesitant/ refusers’ misinformation identification scores seem to have been benefited by the comic strip. The comic strip was better evaluated for trust in its content and acceptance than the educational text. Still, misinformation identification scores were not correlated to any evaluation construct in both groups CS and TX. Transportation into the narrative was positively correlated with all comic strip evaluation constructs but not with the misinformation identification score. Future studies should focus on exploring different styles and sizes of comic strips, using more heterogenous sample and addressing different health topics.

COVID-19 continues to have a major impact on US health and society. Robust research on the epidemiology of acute and post-acute COVID-19 remains fundamentally important to informing policy makers, scientists, as well as the public. This dissertation reports on the development of a large, diverse, United States general population-based meta-cohort with standardized, prospective ascertainment of SARS-CoV-2 and COVID-19, integrated with comprehensive pre-pandemic phenotyping from 14 extant cohort studies. Meta-cohort data were used to investigate risk and resilience factors for incident severe (hospitalized or fatal) and non-severe COVID-19 and correlates of time-to-recovery from SARS-CoV-2 infection. Results support the major acute and post-acute public health impact of COVID-19 and the vital role of modifiable (e.g., obesity, diabetes, cardiovascular disease) and non-modifiable (e.g., age, sex) risk factors for adverse COVID-19 outcomes. Findings suggest that standard primary care interventions—including obesity and cardiometabolic disease prevention and treatment, depression care, and vaccination—remain fundamental to COVID-19 risk mitigation among US adults. Given its longitudinal design and comprehensive pre-pandemic and pandemic-era measurements, the meta-cohort is well suited to support ongoing work regarding the public health impact of SARS-CoV-2 infection, COVID-19, post-acute sequelae, and pandemic-related social and behavioral changes across multiple health domains.