(Mis)communicating about COVID-19: Insights from Health and Crisis Communication

Liberals are Believers: Young People Assign Trust to Social Media for COVID-19 Information

The COVID-19 pandemic has challenged existing health communication strategies as more people turn to social media as a primary health information source. Although many studies have explored how young people use social media, this study examined how sociodemographic factors and political ideology are associated with use and trust in social media as a source for COVID-19 information among young adults, and how use and trust in social media as a COVID-19 information source are associated with their beliefs about COVID-19. In Spring 2021, an online survey was conducted among 2,105 18-29-year-old students at an urban university in California. Our findings show that younger, female, non-binary, Asian, and Black/African American students are most likely to obtain and trust COVID-19 information on social media. Results also suggest that liberal students are more likely to turn to social media as a source for COVID-19 information compared to conservatives. However, conservative students who use social media as a source for information were more likely to believe false health information about prevention measures and the vaccine and to have lower perceived effectiveness of COVID-19 prevention behaviors and vaccination compared to liberals.

Protective behaviors against COVID-19 and their association with psychological factors in China and South Korea during the Omicron wave: a comparative study

OBJECTIVES

We aimed to explore the level of protective behaviors against COVID-19 and its association with psychological factors in China and South Korea during the Omicron wave.

STUDY DESIGN

Cross-sectional study.

METHODS

We conducted a population-based cross-sectional survey from March 15 to 30, 2023 in China and South Korea. Demographic characteristics, health status, protective behaviors, and psychological factors (including perceived risks, efficacy belief, attribution of disease, fear of COVID-19, trust and evaluation, fatalism, resilience, and pandemic fatigue) were investigated. After adjusting for sociodemographic and health-related factors, multivariable regression models were constructed to explore the psychological influencing factors of protective behavior.

RESULTS

A total of 3000 participants from China and 1000 participants from Korea were included in the final analysis. The mean performance score for protective behaviors among all respondents was 2.885 in China and 3.139 in Korea, with scores ranging from 1 to 4. In China, performance scores were higher in those who were female, aged 30-39, employed, married, living in urban areas, having the highest income level, having the best subjective health status, and having a history of chronic disease (P-value <0.05). In Korea, performance scores were higher for individuals who were female, over 50 years old, educated to high school or below, unemployed, married, had a history of chronic disease, and had never been infected with SARS-CoV-2 (P-value <0.05). In the multivariable regression model, perceived severity (β = 0.067), attribution of disease (β = 0.121), fear of COVID-19 (β = 0.128), trust and evaluation (β = 0.097), psychological resilience (β = 0.068), and efficacy belief (β = 0.216) were positively associated with the performance scores, pandemic fatigue (β = -0.089) was negatively associated with performance scores in China (P-value <0.05). However, in Korea, perceived susceptibility (β = 0.075), fear of COVID-19 (β = 0.107), and efficacy belief (β = 0.357) were positively associated with protective behaviors (P-value <0.05), trust and evaluation (β = -0.078) and pandemic fatigue (β = -0.063) were negatively associated with performance scores (P-value <0.05).

CONCLUSIONS

Populations in both China and Korea demonstrated great compliance with protective behaviors during the Omicron wave. Because of the sociocultural, economic, and political differences, there were differences in the association between psychological factors and protective behaviors in the two countries. This study, from the perspective of psychological factors in different cultural contexts, would provide references for increasing adherence to protective guidelines in future outbreaks of emerging infectious diseases.

The Strengths and Weaknesses of Crowds to Address Global Problems

Global climate change, the COVID-19 pandemic, and the spread of misinformation on social media are just a handful of highly consequential problems affecting society. We argue that the rough contours of many societal problems can be framed within a "wisdom of crowds" perspective. Such a framing allows researchers to recast complex problems within a simple conceptual framework and leverage known results on crowd wisdom. To this end, we present a simple "toy" model of the strengths and weaknesses of crowd wisdom that easily maps to many societal problems. Our model treats the judgments of individuals as random draws from a distribution intended to represent a heterogeneous population. We use a weighted mean of these individuals to represent the crowd's collective judgment. Using this setup, we show that subgroups have the potential to produce substantively different judgments and we investigate their effect on a crowd's ability to generate accurate judgments about societal problems. We argue that future work on societal problems can benefit from more sophisticated, domain-specific theory and models based on the wisdom of crowds.

From Message to Messenger: Should Politicians Lead-by-Example to Increase Compliance with Public Health Directives?

This study proposes that in order to increase compliance with government directives during health crises, we should consider the message as well as the messenger. Prior research shows that highly instructional crisis communication increases compliance during acute crisis situations. Crisis communication literature provides no clear answers on how to address prolonged crises like the COVID-19 pandemic, however. We examined the impact of crisis communication on compliance with health directives in March - April 2021, during the third wave of the pandemic in Belgium. Two field experiments were conducted at two different points in time. Participants received an informational message from Belgian authorities, that was either highly instructional or not. Next, they watched a set of messages from traditional and social media, depicting Belgian politicians setting a good or a bad example in terms of adhering to public health directives. Instructional messages only proved to be effective in the first study. Leading-by-example had a stronger impact, especially in study two. During the third wave of COVID-19, Belgian people seemed more inclined to follow public health directives when politicians set the right example, due to an increase in trust in the government. Bad examples, however, decreased compliance.

"Beating Your Head Against the Wall": Burnout on the Rise Among Local Health Department Communication Officials

The COVID-19 pandemic posed unprecedented challenges for frontline healthcare professionals globally. Despite the varied challenges encountered by frontline healthcare professionals, the difficulties faced by public health communication officials in particular has remained an underexplored area of research. This study examined the specific challenges experienced by communication officials during the COVID-19 pandemic in the United States. A qualitative research design was used to conduct in-depth interviews with communication officials working in local health departments (LHDs) in 2022. A total of 14 participants were recruited through purposive sampling, coupled with a data saturation strategy, from LHDs situated in Kansas, Missouri, and Oklahoma. Thematic analysis revealed 3 key themes: (1) main challenges faced by LHDs during the COVID-19 pandemic, (2) challenges related to information dissemination on social media, and (3) burnout experienced by communication officials. This study's findings suggest that communication officials should be provided with the necessary resources and training to effectively handle misinformation, toxic behaviors, and bullying on social media while prioritizing their mental health. In addition, federal, state, and local health agencies should provide timely, clear, and accurate information to address the challenges faced by communication officials in their bid to disseminate information effectively.

Politics Over Public Health: Analysis of Twitter and Reddit Posts Concerning the Role of Politics in the Public Health Response to COVID-19

The purpose of this study is to foster an understanding of the safety, science, and political polarization issues public health officials (PHOs) must navigate in response to the COVID-19 pandemic. This study analyzed posts on two social media outlets, Twitter and Reddit, to understand how political polarization impacted sensemaking around COVID-19. Qualitative analysis revealed that sensemaking around COVID-19 encompasses the following narratives: (a) the concept of public health is ambiguous, (b) political polarization causes burnout amongst PHOs, and (c) political polarization influences sensemaking. The conceptualization of politics was explored and the following themes were found: (d) politics can override public health decisions, (e) politics equates to death and other negative outcomes, (f) politics directly relates to the spreading of misinformation and disinformation, and (g) politics is used as a catch-all for sensemaking about issues in the pandemic that were viewed negatively. We then discuss the theoretical and practical implications of our findings.

Thinking about Social Consequences of COVID-19 Influenced Preventive Intention: The Case of South Korea

Although South Korea has been relatively successful in addressing the COVID-19 pandemic, there were controversies surrounding the negative social consequences (SC) associated with the infection, such as breach of privacy in contact tracing and stigmatization of patients. We examined how individuals' thinking about the SC of COVID-19 infection influenced preventive intention through this specific case, the early phase of the pandemic in South Korea (March, 2020) when concerns regarding SC were very high but vaccines were not available. We theoretically investigated the path from information exposure about COVID-19, worry and risk perception about SC of COVID-19, attitudes/norms/self-efficacy, and preventive intention. An online survey of 805 South Koreans revealed that information exposure about COVID-19 was positively associated with worry and risk perception about the SC, which indirectly predicted preventive intention through attitudes/norms/self-efficacy. As COVID-19 is a new disease, people learned about it from various sources, and contemplated (worry and risk perception) its negative social outcomes. To avoid such negative SC, they might have changed their beliefs toward preventive behavior, which influenced preventive intention. Given that both worry (affective-cognitive state) and risk perception (cognitive evaluation) are related to thinking activities, the findings suggest that individuals' thinking about negative SC of COVID-19 infection might have partly contributed to the success of the early South Korean quarantine model. However, the results also raise critical questions as to how we can protect individuals' lives during a public health crisis.

"I Don't Feel Like a Hero": Frontline Healthcare Providers' Social Media Storytelling during COVID-19

While much of the world watched rising numbers of COVID-19 infections and deaths from the safety of their homes, frontline healthcare providers (FHPs) were face-to-face with a virus that threatened the globe. While our social, political, and economic structures were ill-equipped to handle a global health crisis and our politicization of the disease nurtured divisive dialogues, FHPs pushed their own bodies and minds to unimaginable limits as they witnessed and fought the realities of COVID-19 to care for patients. During and between their extended shifts, FHPs shared their stories on social media platforms, bringing an otherwise hidden perspective of the pandemic to accessible online spaces. In this qualitative study, we analyzed 1 year of FHPs' Twitter posts (March 13, 2020 through March 12, 2021) to engage with the narratives embedded within their tweets. We also interviewed FHPs to learn about their experiences using social media during the pandemic. Findings suggest that FHPs' social media engagement was a communicative effort to cultivate resilience within a context beyond their immediate control while shaping our collective COVID-19 narrative. Twitter served as a permissible public space in which they could manage the tension of being both person and professional, sharing stories of testimony and witness to reveal, manage, and respond to the traumas, vulnerabilities, and injustices they experienced: sacrificing self, caring while pawns to power, and fulfilling responsibility to educate amid contentious spaces.

Roboethics of tourism and hospitality industry: A systematic review

This study aims to give a comprehensive analysis of customers' acceptance and use of AI gadgets and its relevant ethical issues in the tourism and hospitality business in the era of the Internet of Things. Adopting a PRISMA methodology for Systematic Reviews and Meta-Analyses, the present research reviews how tourism and hospitality scholars have conducted research on AI technology in the field of tourism and the hospitality industry. Most of the journal articles related to AI issues published in Web of Science, ScienceDirect.com and the journal websites were considered in this review. The results of this research offer a better understanding of AI implementation with roboethics to investigate AI-related issues in the tourism and hospitality industry. In addition, it provides decision-makers in the hotel industry with practical references on service innovation, participation in the design of AI devices and AI device applications, meeting customer needs, and optimising customer experience. The theoretical implications and practical interpretations are further identified.

Unintended consequences of communicating rapid COVID-19 vaccine policy changes- a qualitative study of health policy communication in Ontario, Canada

BACKGROUND

The success of the COVID-19 vaccination roll-out depended on clear policy communication and guidance to promote and facilitate vaccine uptake. The rapidly evolving pandemic circumstances led to many vaccine policy amendments. The impact of changing policy on effective vaccine communication and its influence in terms of societal response to vaccine promotion are underexplored; this qualitative research addresses that gap within the extant literature.

METHODS

Policy communicators and community leaders from urban and rural Ontario participated in semi-structured interviews (N = 29) to explore their experiences of COVID-19 vaccine policy communication. Thematic analysis was used to produce representative themes.

RESULTS

Analysis showed rapidly changing policy was a barrier to smooth communication and COVID-19 vaccine roll-out. Continual amendments had unintended consequences, stimulating confusion, disrupting community outreach efforts and interrupting vaccine implementation. Policy changes were most disruptive to logistical planning and community engagement work, including community outreach, communicating eligibility criteria, and providing translated vaccine information to diverse communities.

CONCLUSIONS

Vaccine policy changes that allow for prioritized access can have the unintended consequence of limiting communities' access to information that supports decision making. Rapidly evolving circumstances require a balance between adjusting policy and maintaining simple, consistent public health messages that can readily be translated into action. Information access is a factor in health inequality that needs addressing alongside access to vaccines.

Predicting College Students’ Preventative Behavior During a Pandemic: The Role of the Health Belief Model, Source Credibility, and Health Literacy

In this study, we examined the effects of perceived source credibility of the Centers for Disease Control (CDC) and college student health literacy in predicting the likelihood of enacting preventative behaviors related to mitigating COVID-19. Using the Health Belief Model (HBM) as an explanatory tool, we analyzed how perceived source credibility and health literacy levels predict college students’ likelihood to enact preventative behaviors during a public health crisis. Sample population entirely consisted of undergraduate students enrolled in a basic communication course at a large, southern university. The participants completed survey questionnaires about their perceived health literacy, health beliefs, trust in the CDC, perceptions of COVID-19, and demographic measures during the fall 2020 semester. A multiple regression analysis revealed that (a) HBM predictors, health literacy and CDC source credibility accounted for 44% of the variance in likelihood of enacting preventative health behaviors, and (b) health literacy, CDC source credibility, and perceived severity were all positive predictors of enacting preventative health behaviors, while (c) perceived barriers negatively predicted enactment of preventative health behaviors. Perceived susceptibility and perceived benefits were not significant predictors of college student risk mitigation. Our data suggests the importance of health literacy and source credibility in predicting college students’ likelihood to enact preventative behaviors during public health crises.

Knowledge Gaps, Cognition and Media Learning: Designing Tailored Messages to Address COVID-19 Communication Inequalities

Various health and crisis studies have demonstrated support for the existence of knowledge gaps-a hypothesis suggesting that information will reach those in the lower socioeconomic status last, worsening health disparities. At the point at which COVID-19 vaccines were becoming widely accessible, the present study surveyed 651 Black Americans to understand vaccine hesitancy, intentions, and media learning variations after exposure to different types of social media posts about the COVID-19 vaccine. Although exposure to any of the message conditions in our study resulted in a decrease in vaccine hesitancy, we found mixed support for the knowledge gap hypothesis. Results show that lack of knowledge because of socioeconomic status is not a key factor driving vaccine hesitancy among Black Americans. Instead, public communication (government) campaigns may consider focusing on strategies to target Black American communities by age to improve media learning, and consider increasing social control and communal message functions to increase cognitive processing of pro-vaccine messages, and over the longer term, influence COVID-19 vaccine hesitancy and uptake.

Is it an opportunity? COVID-19's effect on the green supply chains, and perceived service's quality (SERVQUAL): the moderate effect of big data analytics in the healthcare sector

This study examines the relationship between uncertainty-fear toward COVID-19, green supply chain management (GSCM), and perceived service quality based on the five dimensions service quality model (SERVQUAL). It also tests the moderating effect of big data analytics (BDA) capabilities. Based on a sample of 300 healthcare managers and customers, we used partial least squares structural equation modeling to analyze the data and test our hypotheses. The empirical results show that the uncertainty-fear toward COVID-19 positively affects GSCM. Also, BDA moderates the relationship between uncertainty-fear toward COVID-19 and GSCM. GSCM positively impacts service quality (empathy, responsiveness, and assurance) but not reliability or tangible items. In addition, GSCM significantly mediates the relationship between uncertainty-fear toward COVID-19 and services' empathy, responsiveness, and assurance. However, it has an insignificant mediation effect regarding reliability and tangible-item dimensions.

Good Trouble in the Time of COVID-19

The rapid circulation of COVID-19 misinformation posed one of the most vexing challenges to health communication scholars and practitioners during the pandemic. Within the communication field, our response to health misinformation has often focused on shoring up public trust in scientific knowledge and amplifying institutional expertise. But this strategy of rebuilding public trust in institutions has a serious weakness: it requires the leaders of these institutions to actually behave in ways that merit trust. This essay tells the story of one such moment when the actions of university leaders threatened to undermine public faith in George Mason University's "safe return to campus" plan. The essay then discusses how a mobilized and organized faculty helped counter this threat by demanding that university leaders embrace transparency, decision-maker accountability, and a commitment to truth-telling based on science.

Health communication needs for COVID-19 prevention and control among college students

Objectives: During the early COVID-19 pandemic, college students had to switch to an online learning and online communication environment facing the chances of information overload, misinformation or conflicting information about COVID-19. This study aims to assess the communication needs that have arisen among college students to shed light on the development of a health communication campaign tailored toward college students. Methods: A series of 10 focus group discussions were conducted with 38 total participants. Each group has 2-6 undergraduate or graduate student participants. Nvivo was used to analyze the transcripts. Results: The students reported that they received conflicting information or misinformation. They requested messages with language that was easy to understand with infographics while being culturally appropriate. They advocated for regular and concise email updates from campus leadership. Most participants also preferred COVID-19 control and prevention information on social media. Conclusion: This study revealed the current status and the needs for health information about COVID-19 prevention and control among college students.

The Influence of Mass Media on the COVID-19 Vaccination Decision-Making Process: A Prospective Survey-Based Study (Preprint)

BACKGROUND

Vaccine hesitancy during the COVID-19 pandemic was exacerbated by an infodemic of conflating accurate and inaccurate information with divergent political messages, leading to varying adherence to health-related behaviors. In addition to the media, people received information about COVID-19 and the vaccine from their physicians and closest networks of family and friends.

OBJECTIVE

This study explored individuals' decision-making processes in receiving the COVID-19 vaccine, focusing on the influence of specific media outlets, political orientation, personal networks, and the physician-patient relationship. We also evaluated the effect of other demographic data like age and employment status.

METHODS

An internet survey was disseminated through the Western Michigan University Homer Stryker MD School of Medicine Facebook account. The survey included questions on media sources for COVID-19 information, political affiliation, presidential candidate choice, and multiple Likert-type agreement scale questions on conceptions of the vaccine. Each respondent was assigned a media source score, which represented the political leaning of their media consumption. This was calculated using a model based on data from the Pew Research Center that assigned an ideological profile to various news outlets.

RESULTS

The sample consisted of 1757 respondents, with 89.58% (1574/1757) of them choosing to take the COVID-19 vaccine. Those employed part-time and the unemployed were at 1.94 (95% CI 1.15-3.27) and 2.48 (95% CI 1.43-4.39) greater odds of choosing the vaccine than those employed full-time. For every 1-year increase in age, there was a 1.04 (95% CI 1.02-1.06) multiplicative increase in odds of choosing to receive the vaccine. For every 1-point increase in media source score toward more Liberal or Democrat, there was a 1.06 (95% CI 1.04-1.07) multiplicative increase in odds of choosing to take the COVID-19 vaccine. The Likert-type agreement scale showed statistically significant differences (P<.001) between respondents; those who chose the vaccine agreed more strongly on their belief in the safety and efficacy of vaccines, the influence of their personal beliefs, and the encouragement and positive experiences of family and friends. Most respondents rated their personal relationship with their physician to be good, but this factor did not correlate with differences in vaccine decision.

CONCLUSIONS

Although multiple factors are involved, the role of mass media in shaping attitudes toward vaccines cannot be ignored, especially its ability to spread misinformation and foster division. Surprisingly, the effect of one's personal physician may not weigh as heavily in one's decision-making process, potentially indicating the need for physicians to alter their communication style, including involvement in social media. In the era of information overload, effective communication is critical in ensuring the dissemination of accurate and reliable information to optimize the vaccination decision-making process.

Trends in the interest in COVID-19 news of the local media and their readers: The case of Spain

The COVID-19 has caused not just an unprecedented sanitary crisis but a social crisis, which has affected, among many other fields, the local journalism, which had to adapt to meet the public's information needs about coronavirus. In this study we analyzed the evolution of local news about COVID-19 in Spain throughout the pandemic by examining local news articles in social media. Using a unique dataset of over 230k Facebook posts published by Spanish local media organizations during 2020 and 2021, we found evidence that the interest of local media in COVID-19, measured as the proportion of the news related to COVID-19, changed as the pandemic evolved. Our results also show that the interest that local media readers had in COVID-19, measured as the proportion Facebook interactions related to COVID-19, was even higher, and also evolved during the pandemic. Although the interest in COVID-19 of local media and their readers essentially progressed in parallel, we also identified some periods in which they behaved differently. While a fatigue with COVID-19 related news would be expected after 2 years of pandemic, a clear decrease of interest was not observed neither in journalists nor in readers.

Factors associated with COVID-19 booster vaccine willingness among migrants from the Eastern Mediterranean living in Australia: a cross-sectional study

Background

Migrants have been disproportionally affected by COVID-19 in Australia. Vaccination against COVID-19 is a key pillar of Australia's public health response, but little is known about the willingness to receive booster vaccinations among migrants. This study aimed to assess the factors associated with a willingness to receive a COVID-19 booster vaccine among migrants living in Australia born in the World Health Organization’s Eastern Mediterranean Region (EMRO).

Methods

A cross-sectional survey was conducted from September to November 2021 (n = 300). Participants were questioned on booster vaccine willingness, sociodemographic characteristics, COVID-19 vaccine information needs and sources, and perceptions of COVID-19 vaccines. Univariate and multivariate logistic regression were used to assess factors associated with booster willingness.

Results

Most respondents (87%) had received two doses of COVID-19 vaccine, of which 81% were willing to receive a booster dose. About half of the participants reported high or very high needs for receiving information about “COVID-19 vaccines’ safety monitoring in Australia”, “COVID-19 vaccines protection against illness”, “Safety of COVID-19 vaccines used in Australia”, and “The Australian COVID-19 vaccination program”. People who were willing to receive a boost dose had significantly higher self-estimated knowledge of COVID-19 vaccines, confidence in COVID-19 vaccines and trust in the Australian government’s vaccine recommendations, and perceived COVID-19 as a greater risk compared to those who were unsure/hesitant. Both groups reported similar perceptions of their personal risks from COVID-19 but diverged on their views of COVID-19 as a broader health problem. There were no statistically significant differences between the two groups in terms of channels used to find information about COVID-19 vaccines. Factors associated with willingness to receive a COVID-19 booster vaccine in the multivariate logistic regression were age (aOR 1.07 95% CI 1.02–1.12), and no exposure to concerning news about COVID-19 vaccines (aOR 3.71 95% CI 1.51–9.09).

Conclusion

Vaccine acceptance and reported booster willingness was high. The results suggest the news and information seen may impact willingness to receive booster doses, even among those who have already received doses of COVID-19 vaccine. Addressing vaccine concerns and transparent communication about uncertainty should be a priority in the current and in future pandemics.

Crisis communication strategies for health officials

Background

Mixed messaging among health officials are prevalent amid COVID-19. Crisis communication strategies have the potential to help health officials effectively address issues such as mixed messages and improve their crisis communication efficacy. However, there is a dearth of insights in the literature. Therefore, to bridge the research gap, this study aims to examine practical strategies health officials can utilize to improve their crisis communication efficacy.

Methods

A literature review on effective crisis communication strategies amid COVID-19 was conducted in PubMed, Scopus, and PsycINFO, with a focus on scholarly literature published in English.

Results

The findings of the study identified the following strategies that health officials can utilize to improve their crisis communication capabilities: (1) develop fact-based, transparent, and accountable messaging, (2) utilize people-centered and empathetic persuasive strategies, and (3) leverage international collaboration for consistent messaging and comprehensive crisis communication.

Conclusion

COVID-19 has challenged health officials with unprecedented crisis communication duties and responsibilities. In this study, we underscored the importance of effective crisis communication amid global health emergencies like COVID-19, and identified communication strategies health officials could adopt or adapt to improve their crisis communication efficacy. Future research could explore strategies health officials can use to better communicate with government officials and media professionals to further help health officials improve their crisis communication capabilities, their abilities to avoid preventable miscommunication or mixed messaging, and in turn, society's collective strengthen in curbing and controlling the pandemic.

An Overview of Innovative Approaches to Support Timely and Agile Health Communication Research and Practice

Innovative approaches are needed to make health communication research and practice more timely, responsive, and effective in a rapidly changing information ecosystem. In this paper we provide an overview of strategies that can enhance the delivery and effectiveness of health communication campaigns and interventions, as well as research approaches that can generate useful data and insights for decisionmakers and campaign designers, thereby reducing the research-to-practice gap. The discussion focuses on the following approaches: digital segmentation and microtargeting, social media influencer campaigns, recommender systems, adaptive interventions, A/B testing, efficient message testing protocols, rapid cycle iterative message testing, megastudies, and agent-based modeling. For each method highlighted, we also outline important practical and ethical considerations for utilizing the approach in the context of health communication research and practice, including issues related to transparency, privacy, equity, and potential for harm.

Individual costs and community benefits: Collectivism and individuals' compliance with public health interventions

Differences in national responses to COVID-19 have been associated with the cultural value of collectivism. The present research builds on these findings by examining the relationship between collectivism at the individual level and adherence to public health recommendations to combat COVID-19 during the pre-vaccination stage of the pandemic, and examines different characteristics of collectivism (i.e., concern for community, trust in institutions, perceived social norms) as potential psychological mechanisms that could explain greater compliance. A study with a cross-section of American participants (N = 530) examined the relationship between collectivism and opting-in to digital contact tracing (DCT) and wearing face coverings in the general population. More collectivistic individuals were more likely to comply with public health interventions than less collectivistic individuals. While collectivism was positively associated with the three potential psychological mechanisms, only perceived social norms about the proportion of people performing the public health interventions explained the relationship between collectivism and compliance with both public health interventions. This research identifies specific pathways by which collectivism can lead to compliance with community-benefiting public health behaviors to combat contagious diseases and highlights the role of cultural orientation in shaping individuals' decisions that involve a tension between individual cost and community benefit.

Understanding Health Information Behaviors of Migrant Domestic Workers during the COVID-19 Pandemic

Migrant domestic workers (MDWs) in Hong Kong remain vulnerable during the COVID-19 pandemic. Obtaining accurate information is essential for MDWs as it helps them understand their predicament and protect themselves. Therefore, this study delves into the MDWs' health literacy by scrutinizing how they acquire, verify, and respond to pandemic-related information. Semi-structured interviews were conducted with 32 Indonesian MDWs, recruited through purposive and snowball sampling. The data were examined using a constant comparative approach in grounded theory. The findings reveal that the participants engaged in information seeking and scanning to obtain health crisis information, mainly through their friends, family members, and community organizations. The participants also verified the information using their judgment or by consulting other actors, such as local organizations and media outlets. The messages they obtained informed the means to protect themselves, which motivated them to adopt preventive measures. However, some also engaged in maladaptive coping, such as taking ineffective preventive actions. The participants also disseminated health crisis information throughout their social circle. This study concluded that MDWs performed four health information behaviors during the pandemic, namely information acquisition, authentication, sharing, and adoption of preventive measures. However, their information practices may change at different stages of the pandemic.

Factors underlying denial of and disbelief in COVID-19

Objective: To investigate factors that influence or promote disbelief and negative attitudes toward COVID-19. Methods: This was cross-sectional study involving 544 males and females = 18 years of age in Greece between December of 2020 and January of 2021. All participants were informed about the purpose of the study, protection of anonymity, and volunteer participation. Participants completed an online anonymous 40-item questionnaire. Analysis of data included the identification of correlations and use of t-tests and ANOVA. Results: The level of knowledge regarding COVID-19 transmission routes, manifestations, and prevention was high in our sample. Women appeared to have a more positive attitude toward COVID-19 prevention and management than did men (p = 0.032 and p = 0.018, respectively). Younger people (18-30 years of age) seemed to deny the validity of scientific data and mass media reports about ways to deal with the pandemic more commonly than did those > 30 years of age (p = 0.003 and p = 0.001, respectively). People who resided in cities more commonly believed in scientific announcements than did those living in villages (p = 0.029). Conclusions: In order to minimize cases of denial of and disbelief in COVID-19 and to promote vaccination, a series of actions are required. Governments should implement a series of measures to contain the disease, taking into consideration the psychological and social aspects of those policies.

Effects of Narrative Messages on Key COVID-19 Protective Responses: Findings From a Randomized Online Experiment

PURPOSE

We investigated the effectiveness of narrative vs non-narrative messages in changing COVID-19-related perceptions and intentions.

DESIGN/SETTING

The study employed a between-subjects two-group (narratives vs non-narratives) experimental design and was administered online.

SUBJECTS/INTERVENTION

1804 U.S. adults recruited via Amazon MTurk in September 2020 were randomly assigned to one of two experimental conditions and read either three narrative or three non-narrative messages about social distancing, vaccination, and unproven treatments.

MEASURES

Perceptions and intentions were assessed before and after message exposure (7-point scales).

ANALYSIS

Using multivariable regression, we assessed main effects of the experimental condition (controlling for baseline measures) and interactions between the condition and pre-exposure perceptions/intentions in predicting post-exposure outcomes.

RESULTS

Compared to non-narratives, narratives led to (1) less positive perceptions about the benefits of unproven treatments (Mnarrative = 3.60, Mnon-narrative = 3.77, P = .007); and (2) less willingness to receive an unproven drug (Mnarrative = 3.46, Mnon-narrative = 3.77, P < .001); this effect was stronger among individuals with higher baseline willingness to receive unproven drugs (baseline willingness = 2.09: b = -.06, P = .461; baseline willingness = 3.90: b = -.30, P < .001; baseline willingness = 5.71: b = -.55, P < .001). Narratives also led to more positive perceptions of vaccine safety/effectiveness, but only among individuals with lower baseline vaccine perceptions (baseline perceptions = 4.51: b = .10, P = .008; baseline perceptions = 5.89: b = .04, P = .167; baseline perceptions = 7: b = -.01, P = .688).

CONCLUSION

Narratives are a promising communication strategy, particularly for topics where views are not entrenched and among individuals who are more resistant to recommendations.

Exploring COVID-19 research papers published on journals in the field of LIS

As the COVID-19 pandemic prevails, research related to COVID-19 has spread beyond medicine, health science, and biology to almost all academic fields. Library and information science is one of the most active fields that publish COVID-19-related research papers. This study examined 696 research papers related to COVID-19 whose journal being categorized as “information science & library science” by Web of Science. The result of bibliometric analysis showed that the publications were active and on the rise. Most papers were published in English and produced in the United States. According to the keyword clustering map produced by semantic network analysis, two fields, bibliometrics and health communication, were publishing research papers related to COVID-19 most actively. Moreover, the most productive journal was a library and information science journal focusing on health informatics. Additionally, a tendency was found that researchers preferred to publish on journals with high impact factors. Compared with non-COVID-19-related research papers, there was a significant decrease of “time for acceptance” of COVID-19-related papers, and the proportion of open access was relatively high. Confronting the global crisis of COVID-19, the library and information science field also made efforts and challenges to resolve the slow peer-review, delayed publishing, and high paywalls, which have been recognized as a “chronic diseases” of the academic publishing ecosystem. It is expected that these endeavors can serve as a turning point to reconsider and innovate the traditional research-publishing lifecycle.

Medical Students' Stress and Uncertainty During the COVID-19 Pandemic

The COVID-19 pandemic triggered extraordinary levels of stress and uncertainty nationwide. In the current study, we use stress and coping theory and uncertainty management theory to examine how medical students coped with the stress and uncertainty associated with the disruption COVID-19 created in their training. Students completed a mixed-methods cross-sectional online survey one week after shifting to online instruction due to COVID-19. The survey included a measure of coping strategies and a series of open-ended questions designed to capture barriers and facilitators of coping and uncertainty management. In total, 360 students from one US medical school completed the survey. Students relied most frequently on coping strategies of distraction, acceptance, planning, positive reframing, and emotional support. However, coping strategies differed significantly by year in training. Personal uncertainty emerged as the most salient form of uncertainty. This uncertainty resulted from the loss of structure and resources, disruption of academic timelines, and, ultimately, disrupted identity as a (future) physician. Students described important barriers and facilitators of coping and uncertainty management. The barriers included constant exposure, inadequate information, rumination, and extreme responses. The facilitators included distraction, avoidance, instrumental support, emotional support, network support, and positive reframing. Overall, our results suggest that medical students experienced significant uncertainty related to their professional skills and identities as future physicians and faced many dilemmas coping with stress and managing uncertainty, mainly related to information and social support.

Risk-Likelihood Perceptions and Preventive Behaviors Against Infectious Diseases: Testing Different Types of Risk-Likelihood Perceptions in the Context of MERS and COVID-19

Effective public health communication should take into the consideration how communicated risk perceptions might influence the public. Although many health behavior theories claim that high perceived risk likelihood motivates preventive health behaviors, this general prediction is complicated by different ways of estimating risk likelihood. Our review of 14 previous studies on perceived risk of infectious diseases revealed different measures of risk likelihood and inconsistent findings regarding the relationship between perceived risk likelihood and behavioral intention. Drawn from the review, we examined the predictive power of different types of risk likelihood on intention to prevent infectious diseases. Using two separate data sets, collected during the 2015 outbreak of the Middle East respiratory syndrome (N = 557) and the COVID-19 pandemic of 2021 (N = 1,001), we demonstrated that perceived risk likelihood that specifies future inaction on health behaviors (i.e., conditional absolute risk perception) better predicted behavioral intention than did other types of risk perceptions. When the effect of conditional absolute risk perception was controlled, the behavioral intention and unconditional absolute risk perception showed a negative relationship. The findings have theoretical and practical implications that can inform strategic communication during future outbreaks.

An application of the extended parallel process model to protective behaviors against COVID-19 in South Korea

This study applied the extended parallel process model (EPPM) to investigate the factors affecting people's preventive behaviors against COVID-19, and thereby, draw relevant policy implications for current and future other epidemics. The EPPM was used to examine the danger control and fear control responses, along with the separate effects of their sub-factors (perceived susceptibility, perceived severity, response efficacy, and self-efficacy) on personal hygiene behaviors, social distancing measures, and fatalism. In total, data from an online survey of 813 adults were analyzed. The results of multiple regression analysis showed a strong effect of self-efficacy on danger control (ß = 0.23 for personal hygiene behaviors, β = 0.26 for social distancing) and fear control responses (ß = -0.13 for fatalism). However, based on the type of control response, the effect of perceived susceptibility and perceived severity, which were the main factors in threat appraisal, was insignificant or marginally significant. Further, a higher perceived severity was associated with higher fatalism in the fear control response (ß = 0.09). Those who were currently employed performed fewer social distancing measures compared to those who did not (ß = -0.11), whereas there was no difference in personal hygiene behaviors. These results suggest that risk communication in emerging infectious disease crises should provide customized information on people who are hard to comply with social distancing. Besides delivering the message of self-efficacy, policies should be implemented to create a social environment in which individuals can practice social distancing without constraints.

COVID-19 Study on Scientific Articles in Health Communication: A Science Mapping Analysis in Web of Science

The COVID-19 pandemic continues to cause a collapse in the health systems and econo-mies of many countries around the world, after 2 years of struggle and with the number of cases still growing exponentially. Health communication has become as essential and necessary for control of the pandemic as epidemiology. This bibliometric analysis identifies existing contributions, jointly studying health communication and the pandemic in scientific journals indexed. A systematic search of the Web of Science was performed, using keywords related to COVID-19 and health communication. Data extracted included the type of study, journal, number of citations, number of authors, country of publication, and study content. As the number of scientific investigations has grown, it is necessary to delve into the areas in which the most impactful publications have been generated. The results show that the scientific community has been quick to react by generating an extraordinary volume of publications. This review provides a comprehensive mapping of contributions to date, showing how research approaches have evolved in parallel with the pandemic. In 2020, concepts related to mental health, mass communication, misinformation and communication risk were more used. In 2021, vaccination, infodemic, risk perception, social distancing and telemedicine were the most prevalent keywords. By highlighting the main topics, authors, manuscripts and journals since the origin of COVID-19, the authors hope to disseminate information that can help researchers to identify subsisting knowledge gaps and a number of future research opportunities.

COVID-19, Genetics, and Risk: Content Analysis of Facebook Posts Early in the Coronavirus Pandemic

The COVID-19 pandemic represented a unique information seeking and sharing context for billions of Internet users across the globe. Although previous research has established that people often seek health information on the Internet, including through social media platforms, there was a political element to pandemic responses that is not typical of health issues such as seasonal influenza or heart conditions. This unique context, in conjunction with the public posting of the novel coronavirus DNA by Chinese scientists in January 2020, begs for analysis of how people used social media in the early phase of the pandemic to make sense of the role of genetics in COVID-19. This study represents such an analysis as a qualitative content analysis of Facebook posts concerning genetics and COVID-19. Data were collected from March through August of 2020 to identify how genetics issues were being shared on Facebook and the types of accounts that were sharing that information. Through analysis, four themes emerged representing Facebook posts about genetics and COVID-19: disease risk, testing, vaccines, and virus characteristics. These posts appeared on eight types of accounts, with five of those representing 88% of the data: education, health, lifestyle, news, and political. Results are interpreted with constructs from media dependency theory and implications for future research are presented.

A brief forewarning intervention overcomes negative effects of salient changes in COVID-19 guidance

During the COVID-19 pandemic, public health guidance (e.g., regarding the use of non-medical masks) changed over time. Although many revisions were a result of gains in scientific understanding, we nonetheless hypothesized that making changes in guidance salient would negatively affect evaluations of experts and health-protective intentions. In Study 1 (N = 300), we demonstrate that describing COVID-19 guidance in terms of inconsistency (versus consistency) leads people to perceive scientists and public health authorities less favorably (e.g., as less expert). For participants in Canada (n = 190), though not the U.S. (n = 110), making guidance change salient also reduced intentions to download a contact tracing app. In Study 2 (N = 1399), we show that a brief forewarning intervention mitigates detrimental effects of changes in guidance. In the absence of forewarning, emphasizing inconsistency harmed judgments of public health authorities and reduced health-protective intentions, but forewarning eliminated this effect.

Predictors of COVID-19 Vaccination Campaign Success: Lessons Learnt from the Pandemic So Far. A Case Study from Poland

The high effectiveness of a vaccination-promotion campaign, which may be measured by the number of those successfully convinced to get vaccinated, is a key factor in combating the COVID-19 pandemic. This, however, appears to be linked to the precise identification of the underlying causes for vaccine hesitancy behaviours. Based on a regression model (adjusted R² of 0.78) analysing 378 sub-regions of Poland, we showed that such behaviours, even when going against the party agenda, can be indirectly yet precisely gauged predominantly through voting patterns. Additionally, education and population density were found to be positively related to low vaccine hesitancy, while markers of social exclusion, both external (employment rate) and psychological (voter turnout) ones, affected it negatively. In the second, follow-up part of our study, which analyses the changes that took place in two months (adjusted R² of 0.53), we found a further increase in vaccination rate to be positively related to the number of those already vaccinated and to the political views of the population, and negatively related to its level of education. In both cases, there was a surprisingly weak relationship between the potential markers of accessibility and vaccination rate. In spite of the known overall differences in vaccination rates for different age and sex groups, these variables did not have any additional informative value in explaining the observed regional differences.

COVID-19 Vaccine Discourse on Twitter: A Content Analysis of Persuasion Techniques, Sentiment and Mis/Disinformation

This research aims to understand the persuasion techniques used in Twitter posts about COVID-19 vaccines by the different vaccine sentiments (i.e., Pro-Vaccine, Anti-Vaccine, and Neutral) using the Elaboration Likelihood Model, Social judgment Theory, and the Extended Parallel Process Model as theoretical frameworks. A content analysis was conducted on a data set of 1,000 Twitter posts. The corpus of Tweets was examined using the persuasion frameworks; tweets that were identified as emanating from bots were further examined. Results found Anti-Vaccine messages predominantly used Anecdotal stories, Humor/Sarcasm, and Celebrity figures as persuasion techniques, while Pro-Vaccine messages primarily used Information, Celebrity figures, and Participation. Results also showed the Anti-Vaccine messages primarily focused on values related to the categories of Safety, Political/Conspiracy Theories, and Choice. Finally, results revealed Anti-Vaccine messages primarily used Perceived Severity and Perceived Susceptibility, which are fear appeal elements. The findings for messages by bots were comparable to the messages in the larger corpus of tweets. Based on the findings, a response framework-Health Information Persuasion Exploration (HIPE)-is proposed to address mis/disinformation and Anti-Vaccine messaging. The results of this study and the HIPE framework can inform a national COVID-19 vaccine health campaign to increase vaccine adoption.

COVID-19 Vaccine Hesitancy Among Adolescent and Young Adult Cancer Survivors

The study objective was to identify sociodemographic and coronavirus disease 2019 (COVID-19) factors that are associated with COVID-19 vaccine hesitancy among adolescent and young adult (AYA) cancer survivors. Eligible participants were 18 years or older and were diagnosed with cancer as an AYA (ages 15-39 years) and received services through an AYA cancer program. A total of 342 participants completed a cross-sectional survey. Our primary outcome—COVID-19 vaccine hesitancy—was surveyed as a 5-point Likert scale and operationalized as a binary outcome (agree vs hesitant). A large proportion of participants reported COVID-19 vaccine hesitancy (37.1%). In the multivariable regression, female survivors (odds ratio = 1.81, 95% confidence interval = 1.10 to 2.98) and survivors with a high school education or less (odds ratio = 3.15, 95% confidence interval = 1.41 to 7.04) reported higher odds of vaccine hesitancy compared with their male or college graduate or higher counterparts. COVID-19 vaccine hesitancy persists among AYA survivors despite their recommended priority vaccination status and higher chances of severe COVID-19 outcomes.

Why Should Businesses Support Public Health?

The COVID-19 pandemic presents a unique opportunity to gain support from the business community for rebuilding a more effective and resilient public health infrastructure in the U.S. This commentary provides the rationale for more engaged business involvement in efforts to promote public health during the time of COVID-19. Drawing on the current pandemic, the commentary highlights the implications of a fragmented public health system for businesses and the nation at large, the shortcomings of which are apparent as never before.

Evaluating Crisis Communication. A 30-item Checklist for Assessing Performance during COVID-19 and Other Pandemics

The primary objective of this paper is to propose a conceptual checklist to assess crisis communication efforts during pandemics and in their aftermath. No consolidated checklist exists for assessing the effectiveness of crisis communication at all levels during pandemics. A literature review was conducted, encompassing articles on crisis communication during SARS, swine flu, H1N1, ZIKA, Ebola, and/or COVID-19. Based on the review, a comprehensive checklist was developed to enable researchers and evaluators to assess and review all important aspects of crisis communication during pandemics. The final Assessment tool for Crisis Communication during Pandemics (ACCP) consists of 30 criteria. Further research is suggested to validate the checklist.

Preparing for A COVID-19 Vaccine: A Mixed Methods Study of Vaccine Hesitant Parents

This study investigated vaccine acceptance of putative COVID-19 vaccines among a national sample of vaccine hesitant parents. Vaccine hesitancy and politicization of vaccine development has led to a pronounced distrust of COVID-19 vaccines in the U.S. A total of 1,381 vaccine-hesitant parents participated in this study. Participants indicated a general unwillingness to vaccinate their children (M = 3.55, SD = 2.13) and themselves (M = 3.58, SD = 2.16) when a COVID-19 vaccine becomes available. More educated parents were more likely to plan to vaccinate themselves [F(5, 533) = 9.93, p < .05] and their children [F(5, 533) = 10.278, p < .05]. Understanding vaccine hesitant parents offers crucial insights as a COVID-19 vaccine becomes available for the general public and as we wait for a vaccine to be approved for pediatric use.