Recently, limited research has begun to explore how public agencies and other orga- nizations are informing the public about PFAS exposure (Ducatman et al., 2022; Har- clerode et al., 2021; National Academies of Sciences, Engineering, and Medicine, 2022; PFAS Exchange, 2021). Ducatman et al. (2022) reviewed o cial health communica- tion messages from federal, state, and local agencies and found that PFAS messaging often fails to adequately inform communities about the potential health risks associated with PFAS exposure by avoiding causal state- ments about the potential negative health impacts of PFAS and instead focusing on the uncertainty of exposure and the fact that research is ongoing. Further, communication often fails to “provide actionable informa- tion” (Ducatman et al., 2022) about what the public can do to reduce exposure. When communicating water health risks, including risks from PFAS exposure, frequent and transparent communication to consum- ers is paramount (Ryan, 2021). Eective methods for increasing awareness of current research include issuing press releases, pub- lishing open-access materials as sources of information, and gaining media attention— all of which increases awareness among both scientific and nonscientific audiences (Fuoco et al., 2023). Multiple researchers have called for high-level social science research that equips public health communicators with how to more strategically inform vulnerable populations, especially when the research being communicated is ongoing and when policies and solutions are in the process of being created and implemented (Berthold et al., 2023; Bruton & Blum, 2017; Harclerode et al., 2021). The first step toward developing eective outreach is to understand the audi- ence’s current questions about PFAS. We draw on the model of communica- tion accommodation theory (CAT) to answer this call. CAT states that audience recep- tion of messages is more positive when the messaging aligns with the audience’s under- standing of an issue and their linguistic preferences (Giles, 2016). In the context of PFAS communication, this model suggests that outreach professionals would benefit from understanding the terminology used and questions asked by search engine users because the internet is often the first stop for information-seeking. Given that the internet
produces a tremendous amount of data daily and that 95% of adults in the U.S. have access to the internet (Pew Research Center, 2024), assessing the content of common searches could help health communicators apply the CAT model strategy of communication align- ment when developing outreach materials and thereby increase audience receptivity. Insights gained from knowing what types of information people seek can then be cou- pled with strategic communications plans to develop and test public health messaging and inform outreach professionals, with the goal of increasing the eectiveness of PFAS messaging. Tailoring informational needs via audience-centered communications strate- gies can increase message relevance, eec- tiveness, and retention (Hawkins et al., 2008; Kidd et al., 2019). To better serve their con- stituencies, public health communicators can benefit from knowing the type and volume of questions being asked about PFAS in drink- ing water. With this knowledge, outreach professionals can focus the content of their messages on what is most relevant to their audience by answering the questions their constituents are likely searching for. Search engine optimization (SEO) research has shown that one of the two factors that best predict if an internet user will visit a website from their search is how closely the website’s information relates to the user’s question (Lewandowski & Kammerer, 2021). Fur- thermore, PFAS are commonly referred to by dierent words: scientific terms for groups of chemicals (e.g., PFAS), specific chemical terms (e.g., PFOS [perfluorooctanesulfonic acid]), and colloquial terms (e.g., forever chemicals) (Cao & Ng, 2021). If users exclusively use colloquial terms in their searches, their search results might exclude credible websites that instead use more scientific terms. Therefore, our first research question (RQ1) identified the use volume associated with PFAS-related keywords and determined which keywords are used most frequently by U.S. Google users. Google has a search engine market share of 87.8% in North America (StatCounter, 2025), making its data largely descriptive of what types of information peo- ple are searching for online. After identifying which terms are used the most by Google users, our study then determined the types of questions Google users are asking regarding the most used keyword categories. Therefore,
the second research question (RQ2) analyzed the types of questions U.S. Google users are asking related to PFAS in their water supplies. Methods To answer RQ1, a list of keywords associated with PFAS was gathered from a consortium of water researchers to ensure our study cap- tured a comprehensive list of related key- words. This list was referenced with and com- plemented by the related keywords provided via Semrush, an analytical service that cre- ates usable information from Google search and Web analytics data. The term used with the highest monthly volume within Google searches was used for the analysis of RQ2. To answer RQ2, Semrush was used to obtain a list of the most frequently asked questions for specific keywords of interest for U.S. users on Google’s search engine. Semrush’s SEO tool was used to review the volume of questions asked about PFAS and water-related keywords. Keyword research is an SEO tool that provides insights into what keywords Google users search for and what information they access based on their search behaviors. Semrush provides avail- able information about keywords of interest by using third-party data providers to col- lect Google search engine data (Semrush, 2025). The volumes of searches within our study are the monthly average searches over a recent 1-year period. Data were captured on July 3, 2024, and included the previ- ous 12 months of search queries related to PFAS in drinking water for U.S. Google users. Because this study focuses on PFAS in drinking water, “PFAS and water” was used as a combined keyword to ensure the context of PFAS questions were related to drinking water. The keyword combination of “PFAS and water” was reviewed to answer RQ2: What are people asking about PFAS in their drink- ing water in the United States? After collect- ing the top 100 questions related to PFAS and water, the first author analyzed the types of questions present within the Semrush list and developed five thematic question categories: 1.What is/are (keyword/s) 2.How to filter or avoid (keyword/s) 3.How to test for (keyword/s) 4.What water products contain (keyword/s) 5.What geographic locations contain (keyword/s)
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July/August 2025 • Journal of Environmental Health
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