About

Michael Mackert, Ph.D., is the Director of The University of Texas at Austin Center for Health Communication and a Professor in the School of Advertising & Public Relations and the Department of Population Health. His research primarily focuses on strategies used in traditional and new digital media to provide effective health communication to audiences with low health literacy. He leads projects on various public health issues, including tobacco cessation, opioid overdose prevention, and men's role in prenatal health, which generate evidence-based health communication strategies and contribute to health communication scholarship.

Research topics

• Political Science
• Computer Science
• Medicine
• Sociology
• Psychology
• Public relations
• Business
• Nursing
• Pedagogy
• World Wide Web
• Medical education
• Virology
• Internet privacy
• Advertising
• Multimedia
• Internal medicine
• Neuroscience
• Pediatrics
• Family medicine
• Mathematics education
• Medical emergency
• Engineering
• Pathology
• Social psychology

Selected publications

• This Treatment Works, Right? Evaluating LLM Sensitivity to Patient Question Framing in Medical QA

  arXiv (Cornell University) · 2026-04-06

  articleOpen access

  Patients are increasingly turning to large language models (LLMs) with medical questions that are complex and difficult to articulate clearly. However, LLMs are sensitive to prompt phrasings and can be influenced by the way questions are worded. Ideally, LLMs should respond consistently regardless of phrasing, particularly when grounded in the same underlying evidence. We investigate this through a systematic evaluation in a controlled retrieval-augmented generation (RAG) setting for medical question answering (QA), where expert-selected documents are used rather than retrieved automatically. We examine two dimensions of patient query variation: question framing (positive vs. negative) and language style (technical vs. plain language). We construct a dataset of 6,614 query pairs grounded in clinical trial abstracts and evaluate response consistency across eight LLMs. Our findings show that positively- and negatively-framed pairs are significantly more likely to produce contradictory conclusions than same-framing pairs. This framing effect is further amplified in multi-turn conversations, where sustained persuasion increases inconsistency. We find no significant interaction between framing and language style. Our results demonstrate that LLM responses in medical QA can be systematically influenced through query phrasing alone, even when grounded in the same evidence, highlighting the importance of phrasing robustness as an evaluation criterion for RAG-based systems in high-stakes settings.

  PublisherOA PDF

• Building a comprehensive model to create tobacco-free cultures on college and university campuses

  Journal of American College Health · 2026-01-20

  article

  The Eliminate Tobacco Use (ETU) Initiative was founded by The University of Texas MD Anderson Cancer Center and The University of Texas (UT) System in 2015 to reduce tobacco use in higher education settings across five campus constituencies-students, faculty, staff, patients, and the community. The operational framework was conceived to design, implement, and advance tobacco control actions involving public policy, awareness programming, and the delivery of tobacco cessation services. With commitment from every UT System president, participating institutions adopted evidence-based strategies, resource sharing, and toolkits. The ETU model attracted interest from colleagues outside of Texas with over 60 institutions/schools and across eight states. ETU has reached more than two million individuals, contributed to healthier academic environments, and served as a model for collaboration and sustainable impact in tobacco control within higher education. Campuses may be able to strengthen their tobacco-control efforts by following the recommendations outlined in this report.

  PublisherDOI

• This Treatment Works, Right? Evaluating LLM Sensitivity to Patient Question Framing in Medical QA

  arXiv (Cornell University) · 2026-04-06

  preprintOpen access

  Patients are increasingly turning to large language models (LLMs) with medical questions that are complex and difficult to articulate clearly. However, LLMs are sensitive to prompt phrasings and can be influenced by the way questions are worded. Ideally, LLMs should respond consistently regardless of phrasing, particularly when grounded in the same underlying evidence. We investigate this through a systematic evaluation in a controlled retrieval-augmented generation (RAG) setting for medical question answering (QA), where expert-selected documents are used rather than retrieved automatically. We examine two dimensions of patient query variation: question framing (positive vs. negative) and language style (technical vs. plain language). We construct a dataset of 6,614 query pairs grounded in clinical trial abstracts and evaluate response consistency across eight LLMs. Our findings show that positively- and negatively-framed pairs are significantly more likely to produce contradictory conclusions than same-framing pairs. This framing effect is further amplified in multi-turn conversations, where sustained persuasion increases inconsistency. We find no significant interaction between framing and language style. Our results demonstrate that LLM responses in medical QA can be systematically influenced through query phrasing alone, even when grounded in the same evidence, highlighting the importance of phrasing robustness as an evaluation criterion for RAG-based systems in high-stakes settings.

  PublisherDOI

• Evaluating Scalable Health Communication Training for Public Health and Healthcare Professionals

  Pedagogy in Health Promotion · 2026-03-16

  articleOpen access1st author

  The COVID-19 pandemic highlighted critical communication challenges within the public health workforce, emphasizing the urgent need for practical, scalable, and accessible training solutions. In response, an academic health communication center developed a Health Communication Training Series (HCTS) featuring asynchronous, online courses designed to strengthen communication skills among public health professionals. This paper presents an evaluation of three free, online courses delivered through a state-funded partnership aimed at bolstering workforce resiliency. A survey of 780 registered learners resulted in 70 completed responses, with participants representing various sectors including public health, higher education, and healthcare. Learners reported meaningful application of course objectives within their professional roles and shared course materials with peers. Feedback emphasized the uniqueness of the courses, citing format, content relevance, instructor expertise, and an engaging design. Participants valued the self-paced structure, timeliness of topics, and real-world applicability. Findings suggest that asynchronous mini-courses are a feasible strategy to meet the dynamic needs of a strained public health workforce, providing timely and relevant skill development in an accessible format. The results also point to the potential of such courses to facilitate professional reflection and peer dialogue. Despite limitations related to response bias and generalizability, the study supports continued investment in flexible, high-quality online education to support ongoing professional development and workforce sustainability in public health.

  PublisherDOI

• “We Keep Each Other Safe”: The Development and Implementation of a Harm Reduction Health Communication Campaign to Prevent Fentanyl Overdoses

  Substance Use & Misuse · 2025-12-17

  articleSenior author

  Fentanyl overdose deaths rose precipitously in the United States from 2015 to 2022, dramatically outpacing all other drugs. Within Texas, Travis County (Austin, Texas) has the highest fentanyl overdose death rate across the state, surpassing larger metro areas such as Houston and Dallas. Local research indicates that many users are aware of fentanyl in the drug supply, but few utilize harm reduction behaviors, indicating the need locally for improved messaging and education among people who use drugs (PWUD). As such, the local health department approached our team to develop a culturally competent, evidenced based health communication campaign rooted in harm reduction principles intended for PWUD as part of a multi-pronged effort to reduce fentanyl-related overdose deaths locally. . Findings of this work support previous research that harm reduction approaches are best poised to support PWUD by providing non-stigmatizing, fact-based information to make informed choices and practice safer substance consumption. Finally, we advocate that by centering both evidence-based strategies with a community-engaged approach, it is possible to create meaningful health communication campaigns that can impart important, time-sensitive health information effectively to marginalized and niche audiences.

  PublisherDOI

• Barriers to Patient Portal Adoption Among a Bilingual Patient Population by Analysis of Survey Findings from English- and Spanish-Speaking Patients: Information Needs Study

  JMIR Formative Research · 2025-05-21 · 1 citations

  articleOpen access

  Background: Despite legislative action, pre-existing barriers continue to prevent patients from using patient portals. Patients, especially older people, people of color, and people with limited English proficiency continue to experience difficulty in adopting patient portals. Objective: The aim of this study was to advance understanding, explore willingness to adopt an electronic portal, and examine differences between language preferences. Methods: English- and Spanish-speaking patients (N=106) were surveyed from a community clinic regarding access to electronic devices and the internet, barriers to using a patient portal, willingness to adopt such a portal, preference mode of communication with health care providers, and preferred features in the current clinic's portal. Linear and logistic regressions were performed to predict the probability that patients would adopt the patient portal. Results: Only 65% (n=69)of participants said they envisioned themselves using a patient portal. English-speaking patients were more willing to exchange electronic information with their health care providers. Spanish-speaking patients reported language as a significant barrier to portal use. A logistic regression revealed that patients with more positive attitudes and higher perceived behavioral control are more likely to sign up and use the patient portal (Nagelkerke R2=.51, classification=90.8%, efficacy B=2.38, Wald-1=5.93, P=.02 and Exp[B]=12.44, attitude B=1.87, Wald=6.45, P=.01, Exp[B]=7.49). Conclusions: Understanding language preference differences while predicting portal use based on attitudes and perceptions empowers patients to have a more meaningful experience with their physician, potentially overcoming low health literacy-related barriers.

  PublisherDOI

• Hispanic Views About Online Information on Weight Gain, Diet, and Physical Activity in Pregnancy: A Qualitative Study

  Global Qualitative Nursing Research · 2025-04-17

  articleOpen accessSenior author

  The vast amount of online health resources accessible to the public and the pregnant population shows their high interest in using online health resources for their pregnancies. In this study, we specifically aimed to understand the experience and use of online pregnancy health information among Hispanic individuals, who are at higher risk of gaining outside of the recommended guideline of gestational weight gain (GWG) than the overall U.S. childbearing population. We conducted face-to-face semi-structured interviews with 20 childbearing-age Hispanic individuals (who were either pregnant or non-pregnant) in the Austin area to explore seeking, understanding, and using online information about recommendations for GWG, diet, and physical activity during pregnancy. Using reflexive thematic analysis, we identified both user perspectives and website features that affected the participants' engagement with and application of online pregnancy information. We conclude that the benefits of online resources fill gaps left by healthcare providers. Nurses as care providers and content creators of health information can help translate guidelines into behaviors that Hispanic people could apply in their everyday lives.

  PublisherDOI

• Public Understanding and Perception of Harm Reduction and Prevention Messaging About Fentanyl Overdoses

  Substance Use & Misuse · 2025-03-17 · 1 citations

  article

  BACKGROUND: Fentanyl-related opioid fatalities have risen drastically in the United States, indicating a "new wave" of the opioid crisis and highlighting the urgent need for more effective public health interventions to address its harms. Despite an increasing number of public communication campaigns focused on the general public, evidence on how people perceive fentanyl-related harm reduction strategies and prevention messaging is still nascent. METHODS: . RESULTS: . CONCLUSIONS: Findings indicate that harm reduction and prevention messages hold the potential to be effective in reducing the harmful consequences of fentanyl overdoses. Future research should examine whether favorable message perceptions can translate into actual effectiveness and behavioral changes, which could have implications for the development of public health interventions.

  PublisherDOI

• Understanding dental hygienists’ knowledge, attitudes, and practices regarding HPV vaccination

  Human Vaccines & Immunotherapeutics · 2025-05-30

  articleOpen access

  = 380) were analyzed due to an insufficient sample size of dentists. Mostly female, White, and practicing in urban areas, hygienists had overall low awareness of the high prevalence of HPV and HPV vaccine efficacy in preventing several types of HPV-associated cancers. While the discussion of the HPV-oropharyngeal cancer link was perceived as relevant to their practice, participants generally disagreed with administering the vaccine in the dental office. Less than half of participants believed they were responsible for recommending the vaccine with low perceived knowledge and self-efficacy to discuss HPV vaccination with parents of adolescents. Despite the current lack of HPV vaccine recommendations in their practice, more than half of the participants were willing to educate their patients about the importance of the vaccine to prevent oropharyngeal cancer. HPV-focused educational interventions tailored to oral health practice may improve dental hygienists' confidence and motivation to promote HPV vaccination for oral cancer prevention.

  PublisherDOI

• Understanding conversations on alcohol across diverse Reddit communities: a computational analysis

  Journal of Computational Social Science · 2025-09-05 · 1 citations

  articleSenior author
  PublisherDOI

Frequent coauthors

• Allison J. Lazard

  University of North Carolina at Chapel Hill

  39 shared

• Sara Champlin

  University of North Texas

  37 shared

• William L. England

  25 shared

• Gina Perez

  University of Miami

  25 shared

• Kathryn Cristaldi

  Medical University of South Carolina

  25 shared

• Pamela Whitten

  22 shared

• Marie Guadagno

  Mitre (United States)

  21 shared

• Erin E. Donovan

  Massachusetts General Hospital

  15 shared