The cognitive mediation model: factors influencing public knowledge of the H1N1 pandemic and intention to take precautionary behaviors

Reconsidering the Effectiveness of Fear Appeals: An Experimental Study of Interactive Fear Messaging to Promote Positive Actions on Climate Change

Masspersonal communication has emerged as a compelling alternative persuasive approach in response to the widespread use of social media. It is crucial to comprehend how observing online interpersonal interactions regarding the fear appeal of climate change can foster pro-environmental behaviors among users. This study examines the effects of vicarious message interactivity in promoting actions against climate change and the underlying mechanisms behind this effect. The results of an online experiment conducted in China (N = 236) revealed that psychological reactance and message elaboration mediated the effects of vicarious message interactivity on behavioral intention in a serial indirect effect. In comparison to static fear appeal, interactive fear appeal proves effective in reducing psychological reactance, promoting message elaboration, and ultimately increasing intention to take actions against climate change. Our findings not only contribute to the literature on interactive communication but also provide insights for environmental-health campaigns on social media.

Talking About Prescription Opioid Misuse: The Effect of Family Communication Patterns and Messages Advocating Direct and Indirect Communication

Families play an important role in addressing substance misuse and addiction. Extant literature suggests patterns of communication within families influence the ways in which they engage loved ones who may be misusing substances like prescription opioids. However, little is known regarding how strategic health messages about family communication influence individuals' intentions to engage in conversations about substance misuse. Applying a normative approach, we conducted a (2 × 2) between-participants experiment examining whether messages advocating indirect (versus direct) communication are more effective for individuals (n = 613) who describe their family as having a low (versus high) conversation orientation. Univariate analysis of variance tests show match effects for message attitudes and message elaboration. For intentions to talk with a loved one about the risks of OUD, there was only evidence of a matching effect between the message advocating indirect communication with low conversation audiences. Both message types were equally effective at influencing intentions for high conversation participants. These findings suggest message designers should consider the kinds of communication behaviors and actions advocated in appeals targeting family members. Messages that are inclusive of the conversation dynamics of particular audiences may have greater effect. In particular, for low conversation audiences, messages advocating an indirect approach may be more effective at motivating intentions to engage someone who is misusing opioids.

"I Know News Will Find Me": Examining the Relationship Between the "News-Finds-Me" Perception and COVID-19 Misperceptions

In the current media environment, some individuals have shifted from actively monitoring news toward passively waiting for the media to alert them about news to a certain extent, forming a "news-finds-me" (NFM) perception. Drawing on a cross-sectional survey (N = 906) of adults from the United States, this study investigates the relationship between the NFM perception and COVID-19 misperceptions. Findings demonstrated a positive association between NFM perception and misperceptions. Moreover, information avoidance mediated the relationship between NFM and misperception. Finally, need for cognition (NFC) was a significant moderator, such that among those with greater NFC, the indirect effect of NFM perception on misperceptions became weaker. Findings of this study can contribute to the literature of NFM perception in health contexts and provide useful guidelines for combating misinformation and misperceptions in the algorithm-generated information environment.

Predicting Public Cooperation with Face Covering at the Early Phases of COVID-19: Building Public Trust, Confidence, Knowledge Through Governmental Two-Way Symmetrical Communication

Despite the agreement on the importance of two-way communication during governmental response to pandemics, few studies provided empirical evidence to support the effectiveness of such communication strategy in times of a public health crisis. Integrating the concept of two-way symmetrical communication and the Trust, Confidence, and Cooperation model (the TCC model), this study investigates how strategic communication practices, in particular two-way symmetrical communication, is related to public's perceived trust and confidence in governments (i.e., CDC in this study), and how these perceptions may affect decisions to comply with the preventive behaviors (i.e., face covering in this study), while taking the moderating role of knowledge into consideration. An online survey was conducted with 502 participants who were living in the United States in early April 2020. The findings showed that two-way symmetrical communication may increase public trust and confidence in governments, and improve individuals' knowledge about the pandemic, which all subsequently leads to compliance with recommended behaviors. The results contribute to the theoretical understanding of pandemic communication and provide implications for practitioners in pandemic management, suggesting that health institutions should adopt two-way symmetrical communication practices in respond to public health emergencies.

Questions of value, questions of magnitude: An exploration and application of methods for comparing indirect effects in multiple mediator models

Mediation analysis is widely used to test and inform theory and debate about the mechanism(s) by which causal effects operate, quantitatively operationalized as an indirect effect in a mediation model. Most effects operate through multiple mechanisms simultaneously, and a mediation model is likely to be more realistic when it is specified to capture multiple mechanisms at the same time with the inclusion of more than one mediator in the model. This also allows an investigator to compare indirect effects to each other. After an overview of the mechanics of mediation analysis, we advocate formally comparing indirect effects in models that include more than one mediator, focusing on the important distinction between questions and claims about value (i.e., are two indirect effects the same number?) versus magnitude (i.e., are two indirect effects equidistant from zero or the same in strength?). After discussing the shortcomings of the conventional method for comparing two indirect effects in a multiple mediator model-which only answers a question about magnitude in some circumstances-we introduce several methods that, unlike the conventional approach, always answer questions about difference in magnitude. We illustrate the use of these methods and provide code that implements them in popular software. We end by summarizing simulation findings and recommending which method(s) to prefer when comparing like- and opposite-signed indirect effects.

How scared are Americans of the Zika virus? The role of threat, efficacy, and third-person perception to induce protective behaviors

This study examines how public perception of threat and efficacy (on self and others) influence their tendency to take preventive action against the Zika virus by surveying 1,152 U.S. adults in Texas and Florida. Findings show that individuals were likely to take protective actions when they: (1) saw a high risk of the disease (high threat) and were confident about their ability to reduce the danger (high efficacy); and (2) perceived others as having a high risk (high threat), but lacked the ability to reduce the danger (low efficacy). Further, the study discusses practical implications for the design of public health campaigns.

Association between trust in COVID-19 information sources and engaging in infection prevention behaviors in Japan: A longitudinal study

OBJECTIVE

We examined changes in people's trust in information sources in Japan during the COVID-19 pandemic over the course of 1 year and investigated longitudinal associations between trust in such sources and engaging in infection prevention behaviors.

METHODS

We conducted a longitudinal survey of Japanese populations under a declared state of emergency at two time points, August 2020 and August 2021. We surveyed sociodemographic data, seven Trust in COVID-19 information sources and six COVID-19 preventive behaviors.

RESULTS

In all, 784 participants completed the two surveys. Physicians were the most consistently trusted information source over the 1-year period. We identified three preventive behaviors that were positively associated with trust in physicians as an information source (social distancing, wearing masks, and washing hands with soap), four preventive behaviors that were positively associated with trusting infected patients (social distancing, using ventilation, wearing masks, and using hand sanitizer), and one preventative behavior that was negatively associated with trust in government (avoiding closed spaces).

CONCLUSION

In the ongoing pandemic, information from physicians and patients may encourage people to engage in long-term preventive behaviors.

PRACTICE IMPLICATIONS

Physicians and patients should be promoted as trusted and behavior influencing sources of information during the pandemic.

How Motivation to Reduce Uncertainty Predicts COVID-19 Behavioral Responses: Strategic Health Communication Insights for Managing an Ongoing Pandemic

During highly uncertain times such as the coronavirus disease 2019 (COVID-19) pandemic, it is vital to understand and predict individuals’ responses to governments’ crisis and risk communication. This study draws on the Orientation-Stimulus-Orientation-Response (O-S-O-R) model to examine (1) whether uncertainty reduction motivation (a pre-orientation factor) drove Americans to turn to traditional news media and/or social media (stimuli) to obtain COVID-19 information; (2) if these media preferences shaped their COVID-19 knowledge, cognitive information vetting, and trust in government communication (post-orientation factors); and finally (3) whether these factors contributed to their intended and actual behaviors (responses), such as getting vaccinated. Thus, this study explores how multiple communicative and cognitive mechanisms contribute to public compliance with government health recommendations during a pandemic. Mediation analyses showed positive indirect effects between uncertainty reduction motivation and behavioral outcomes via use of social media (in relation to traditional news media) and COVID-19 knowledge and cognitive information vetting. This study discusses theoretical and practical health communication implications of these findings.

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.

Social Distancing during the COVID-19 Pandemic in Switzerland: Health Protective Behavior in the Context of Communication and Perceptions of Efficacy, Norms, and Threat

The success of health protection measures depends on public compliance. This paper aims to understand the influence of three different types of communication (i.e., news media, social media, and interpersonal communication) on people's engagement in health protective behavior during a public health crisis. Our C-ENT model of health protective behavior proposes that communication raises perceptions of efficacy, norms, and threat, which in turn influence health protective behavior (communication → efficacy, norms, threat: C-ENT). We test the model for the case of social distancing during the COVID-19 pandemic, based on a representative online survey during the first week of the lockdown in Switzerland (N = 1005). The results support the C-ENT model and illustrate the important role of communication engagement during a public health crisis. News media use was associated with perceptions of behavior-related efficacy and norms and disease-related threat, and these perceptions were positively associated with compliance with social distancing. Social media use and interpersonal communication were related with perceived norms. Social media use was negatively and interpersonal communication positively associated with health behavior-supporting normative perceptions. Our findings suggest taking the distinct pattern among communication types (i.e., news media, social media, and interpersonal communication), perceptions, and behavior into account in order to understand existing dependencies and design respective communication strategies.

'Shoot them dead': rhetorical constructions of the COVID-19 pandemic in Philippine presidential addresses

BACKGROUND

This paper argues that public addresses of heads of state are critical for public health policy during pandemics. Drawing insights from studies that investigate metaphors and frames in political and public health discourses, it explores how the Philippine government, especially President Rodrigo Duterte, framed COVID-19. In doing so, it hopes to broaden the understanding of how political rhetoric may be constitutive of public health policy.

METHODS

The analysis of the public addresses entailed three interrelated levels: (1) a description of broad historical, social, political, and cultural contexts of public addresses under investigation, (2) an explanation of the communicative situation including the production and consumption of these addresses-processes that mediate between the text and context, and (3) a textual analysis, which substantiates how the discursive patterns are realized through the president's rhetorical choices.

RESULTS

Our analysis reveals that the president consistently deployed the rhetorical strategies of (1) enemization, (2) legitimization of the incumbent administration, and (3) dismissal of critics. The configuration of these strategies sustains a binaristic discourse structure that lays blame on a political other while the government asserts its legitimacy during a public health crisis.

CONCLUSIONS

These rhetorical strategies organize support for public health policy by a populist administration to manage COVID-19. Implications of political rhetoric to public health and risk communication are discussed.

Research on Knowledge Learning of COVID-19 Video Viewers: Based on Cognitive Mediation Model

During the COVID-19 epidemic, social media has become the main channel for people to learn information related to the epidemic, among which information in the form of videos has played a significant role in the prevention and control of COVID-19. However, few studies have analyzed the process of knowledge learning of individuals through watching COVID-19 videos. Therefore, to explore the process of COVID-19 video viewers' knowledge acquisition, this paper constructs a knowledge learning path model based on the cognitive mediation model and dual coding theory. A sample of 255 valid questionnaires was collected to validate this model. The results of this study show that an individual's perceived risk of COVID-19 affects their surveillance motivation positively, while surveillance motivation further stimulates the attention and elaboration about the information in COVID-19 videos. Among them, attention positively influences the elaboration about the information. Ultimately, both an individual's attention and elaboration positively influence the knowledge he or she acquires from the COVID-19 videos. This paper not only verifies the hypothesized relationships in the original cognitive mediation model, but also extends the model to the context of video knowledge learning. Analyzing the knowledge learning process of COVID-19 video viewers, this paper can provide suggestions for government propaganda departments and relevant media to improve public knowledge of COVID-19.

Associations between Vaccination Behavior and Trust in Information Sources Regarding COVID-19 Vaccines under Emergency Approval in Japan: A Cross-Sectional Study

We examined the association between COVID-19 vaccination behavior and trust in COVID-19-related information sources during the initial period of COVID-19 vaccination in Japan. A cross-sectional survey was conducted in August 2021, 5 months after the start of COVID-19 vaccination for the general public under emergency approval. Participants were recruited using non-probability quota sampling from among Japanese residents who were under a declared state of emergency. Sociodemographic data, vaccination behavior, and levels of trust in eight media sources of information and three interpersonal information sources were assessed using an online survey form. A total of 784 participants completed the survey. The results of multiple logistic regression analysis showed that age, household income, underlying medical conditions, and living with family were significantly associated with COVID-19 vaccination behavior. Regarding COVID-19 vaccine information sources, trust in public health experts as a source of media information and primary care physicians as a source of interpersonal information showed significantly positive associations with COVID-19 vaccination behavior (odds ratio [OR] = 1.157, 95% confidence interval [CI] 1.017-1.31; OR = 1.076; 95% CI 1.006-1.150, respectively). Increasing trust in public health experts and primary care physicians and disseminating vaccine information from these sources will help promote vaccination under emergency approval.

Pathway linking health information behaviors to mental health condition during the COVID-19 infodemic: A moderated mediation analysis

Background

The COVID-19 outbreak is no longer a pure epidemiological concern but a true digital infodemic. Numerous conflicting information and misinformation occupy online platforms and specifically social media. While we have lived in an infodemic environment for more than 2 years, we are more prone to feel overwhelmed by the information and suffer from long-term mental health problems. However, limited research has concentrated on the cause of these threats, particularly in terms of information processing and the context of infodemic.

Objective

This study proposed and tested moderated mediation pathways from two types of health information behaviors (social media engagement and interpersonal communication) on information overload and mental health symptoms-long-term stress.

Methods

We conducted a cross-sectional online survey between May and June of 2021 among the Malaysian public. The final sample size was 676 (N = 676). A conceptual model was built to guide the data analysis. We conducted structural equation modeling (SEM), moderation and mediation analyses to examine each direct pathway, moderating and mediating effects.

Results

According to the pathway analysis, we found that, during the infodemic period, engaging COVID-19 information on social media positively associated with information overload, but interpersonal communication was negatively related to it. As the proximal outcome, there was also a positive association between information overload and the final outcome, perceived stress. The moderation analysis only reported one significant interaction: risk perception weakened the association between social media engagement and information overload. A conditional indirect effect was demonstrated and the indirect associated between social media engagement and perceived stress mediated through information overload was further moderated by COVID-19 risk perception.

Conclusion

This research offers new grounds for understanding health information behaviors and their consequences in the COVID-19 infodemic. We particularly highlighted the distinct functions of health information behaviors in causing information overload, as well as the importance of personal health belief in this process. Our proposed model contributes to the strategies of developing health messaging strategies that may be utilized by public health researchers and health educators in the future.

Thinking, not talking, predicts knowledge level: Effects of media attention and reflective integration on public knowledge of nuclear energy

By applying the cognitive mediation model, this study seeks to investigate factors influencing public knowledge of nuclear energy in Singapore. In addition, this study seeks to extend the cognitive mediation model by explicating the knowledge variable into four facets - general science knowledge, perceived familiarity, content nuclear knowledge and contextual nuclear knowledge. Using data collected from an interviewer-led door-to-door survey with 1000 Singapore citizens and permanent residents (PRs), we found that attention to TV news, website news and social media news stimulated news elaboration and interpersonal discussion. However, attention to print newspaper was neither associated with news elaboration nor interpersonal discussion. We also found that news elaboration could enhance factual knowledge such as general science knowledge, content nuclear knowledge and contextual nuclear knowledge, while interpersonal discussion could enhance perceived familiarity. Theoretical and practical implications are discussed.

The Effects of Receiving and Expressing Health Information on Social Media during the COVID-19 Infodemic: An Online Survey among Malaysians

Social media is used by the masses not only to seek health information but also to express feelings on an array of issues, including those related to health. However, there has been little investigation on the influence of expressing and receiving information in terms of health-related engagement on social media. Moreover, little is known of the cognitive mechanisms underlying the expression and reception of health information on information overload (IO) during an infectious disease outbreak. Guided by the Cognitive Mediation Model (CMM), this study proposes a conceptual model to understand the effects of receiving and expressing COVID-19 information on social media on IO. Using an online survey conducted in Malaysia, our results indicated that risk perception positively predicted the reception and expression of information which, in turn, was positively associated with perceived stress and IO. Additionally, perceived stress triggered IO, indicating that the greater the perceived stress from health information engagement, the higher the likelihood of one experiencing IO during the pandemic. We conclude that the CMM can be extended to study IO as an outcome variable. More studies in diverse health contexts need to be conducted to enhance the conceptualization and operationalization of IO in health information processing.

The Effects of Social Media Information Discussion, Perceived Information Overload and Patient Empowerment in Influencing HPV Knowledge

Social media is becoming a viable channel to seek health information. However, the effects of social media on health knowledge have been inconsistent in the existing literature. Drawn upon the cognitive mediation model, this study examined the motivations influencing social media use for human papillomavirus (HPV) information and explored the underlying pathways linking social media use to HPV knowledge. With two-wave online surveys conducted in China, we found that three motivations of social media use, namely surveillance, anticipated interaction, and guidance, were positively associated with information discussion on social media, which increased perceived information overload that was negatively related to knowledge. In addition, patient empowerment positively moderated the effects of motivations on information discussion.

Service innovation in the restaurant sector during COVID-19: digital technologies to reduce customers' risk perception

Purpose

This paper investigates the extent to which the COVID-19 pandemic has accelerated service innovation in the restaurant sector. It explores the use of digital technologies (DT) as a safety-empowerment and resilient strategy in the food-service industry during the pandemic. It also investigates the impact of DT on customers' risk perception (CRP) and customers' intention to go to restaurants (CIR) in Italy.

Design/methodology/approach

Based on the theory of planned behaviour and perceived risk theory, this study investigates a sample of customers residing in Italy. Multiple regression and mediation analyses are conducted to test the research hypotheses, adapting the logic model developed. Using the bootstrapping technique, this study also explores whether the pandemic has moderated the relationship among several variables adapted from the literature. Robustness tests are also performed to corroborate the analysis.

Findings

The pandemic has accelerated the food-service industry's digital transformation, forcing restauranteurs to implement DT to survive. Findings show that DT support restauranteurs in implementing innovative services that reduce interactions and empower cleanliness among workers and customers, reducing CRP and preserving CIR. Thus, managing risk perception is helping the restaurant sector to recover.

Practical implications

Practical implications are presented for policymakers to catalyse the digital transformation in small- and medium-sized restaurants. The results may also be beneficial for entrepreneurs who can implement innovative service practices in order to reduce interaction and empower cleanliness levels. Moreover, academics can use these results to conduct similar research in other geographical contexts.

Originality/value

The present research represents the first study investigating the relationship between the use of digital technologies and the intentions of customers to go out for dinner during the ongoing pandemic in Italy.

Promoting COVID-19 Vaccination Using the Health Belief Model: Does Information Acquisition from Divergent Sources Make a Difference?

As a promising approach to stop the escalation of the pandemic, COVID-19 vaccine promotion is becoming a challenging task for authorities worldwide. The purpose of this study was to identify the effective sources for disseminating information on the COVID-19 vaccine to promote individuals' behavioral intention to take the vaccine. Based on the Health Belief Model (HBM), this study illustrated the mechanism of how COVID-19 information acquisition from different sources was transformed into vaccination intentions via health beliefs. Using an online survey in China, the structural equation model results revealed that perceived benefits and cues to action were positively associated with COVID-19 vaccination intentions, and perceived barriers were negatively related to the intentions. However, perceived susceptibility and perceived severity had no significant relationships with the intentions. Moreover, the findings unveiled differences in the effects of acquiring information via multiple sources among traditional media, new media, and interpersonal interactions. Notably, new media and interpersonal interactions were more salient in promoting vaccination intention via health beliefs, compared with traditional media. The findings from this study will benefit health officials in terms of utilizing different information sources in vaccine programs.

Factors influencing COVID-19 vaccination intention: The roles of vaccine knowledge, vaccine risk perception, and doctor-patient communication

OBJECTIVE

This study aims to investigate factors influencing COVID-19 vaccination intention in the United States.

METHODS

A cross-sectional survey was conducted with 800 respondents recruited from an online panel managed by a survey company. Path analysis was employed to examine the relationships between the study variables.

RESULTS

First, perceived susceptibility to COVID-19 vaccine side effects was negatively associated with vaccination intention whereas perceived severity did not show any significant impact. Second, vaccine-related knowledge was not directly related to vaccination intention, but it had an indirect and positive effect on vaccination intention via decreasing perceived susceptibility. Third, doctor-patient communication strengthened the negative effect of vaccine knowledge on perceived susceptibility and severity.

CONCLUSION

The results of this study offer insights on how to increase people's vaccination intention and reduce their psychological concerns when making COVID-19 vaccine-related decisions.

PRACTICE IMPLICATIONS

Government agencies should actively promote the effectiveness and importance of vaccination, while addressing concerns about vaccine safety in the public; Health initiatives also need to enhance the level of knowledge about COVID-19 vaccines through various media channels; Doctors can start the conversations about COVID-19 vaccination with their patients at the point of care and/or via online communication platforms.

A communication inequalities approach to disparities in fruit and vegetable consumption: Findings from a national survey with U.S. adults

OBJECTIVES

This study assessed whether socioeconomic disparities in fruit and vegetable consumption and its differences by social capital are accounted for by exposure to media information about fruits and vegetables and reflective integration of that information.

METHODS

Online survey data were collected in July 2014 from 572 U.S. adults from a nationally representative online panel. Path analysis was employed to test our models.

RESULTS

Education and social capital were positively associated with media exposure, which was in turn positively related to reflective integration and finally led to fruit and vegetable consumption. Education and income were positively associated with social capital.

CONCLUSION

Differences in fruit and vegetable consumption across social groups are at least partly explained by exposure to information about fruits and vegetables from the media, and by reflective integration of that information.

PRACTICE IMPLICATIONS

Healthcare professionals and health educators should create health messages delivered via the media that are easy to understand with an appropriate level of health literacy. Also, health interventions that aim to build social capital may promote health media use and its reasoning processes, thereby reducing communication inequalities by SES as well as disparities in fruit and vegetable consumption.

Linking Risk Perception to Breast Cancer Examination Intention in China: Examining an Adapted Cognitive Mediation Model

Drawn upon the cognitive mediation model, this study proposes an adapted model and examines the mechanisms by which Chinese women's risk perception of breast cancer becomes associated with their breast cancer examination intention. Our hypothesized model was largely supported by an online survey with a nationwide sample of 458 Chinese women. The results indicated that a person's perceived risk for breast cancer motivated information seeking and scanning using various mass media and online channels, which then positively predicted the person's quest for greater elaboration and more interpersonal discussion. In addition, elaboration was positively associated with breast cancer-related factual knowledge and subjective norms, whereas interpersonal discussion only exerted a positive relationship with subjective norms but not factual knowledge. As predicted, knowledge and subjective norms were positively associated with people's intentions to pursue breast cancer examination. Future research should consider both information seeking and scanning in the process of media learning and reflection. In addition to intrapersonal factors like knowledge, the interpersonal reasoning process that cultivates a favorable social influence is pivotal in promoting breast cancer examination in China.

The Impact of Social Media Exposure and Interpersonal Discussion on Intention of COVID-19 Vaccination among Nurses

COVID-19 vaccine hesitancy among nurses is a global public health concern and it is imperative to understand associated factors. Information environment plays a critical role in shaping health behaviors, while few studies explored such effects in the context of COVID-19 vaccination. A cross-sectional survey was conducted among 1902 nurses in China. The study investigated the effects of social media exposure/interpersonal discussion on intention of COVID-19 vaccination and tested whether perceived effectiveness of COVID-19 vaccines (perceived vaccine efficacy, perceived duration of protection, and perceived effectiveness in preventing resurgences) mediated such associations. Results showed that about 68.0% and 56.5% of the participants had an intention of free and self-paid COVID-19 vaccinations, respectively. Frequent social media exposure and interpersonal discussion were positively associated with vaccination intentions. Perceived vaccine efficacy significantly mediated the effects of frequent social media exposure and interpersonal discussion, whereas perceived effectiveness in preventing resurgences suppressed the effects of frequent social media exposure. In conclusion, the prevalence of intention of COVID-19 vaccination was relatively low among Chinese nurses and health promotion is needed. Frequent social media exposure and interpersonal discussion potentially enhanced vaccination intentions via increased perceived vaccine efficacy. The findings can help inform the development of relevant health communication interventions.

Burden, Depression, and Awareness of Information on Safety Behavior in Korean Hemodialysis Patients during the COVID-19 Pandemic

The purpose of this study was to investigate the relationships among burden, depression, awareness of information (AIC), and safety behavior among hemodialysis patients in Korea during the COVID-19 pandemic. The study participants included 149 patients who received hemodialysis at seven general hospitals in Korea between January and February 2021. A structured questionnaire was used to survey their levels of burden, depression, AIC, adherent safety behavior (ASB), and dysfunctional safety behavior (DSB). The study results showed that the influencing factors of ASB for COVID-19 were AIC (β = 0.265, p < 0.001), the burden of “not receiving hemodialysis on time” (β = 0.233, p = 0.008), and the burden of “social exclusion of hemodialysis patients” (β = 0.186, p = 0.032). The influencing factors of DSB were the burden of “social exclusion of hemodialysis patients” (β = 0.258, p = 0.003) and AIC (β = 0.217, p = 0.004). As the COVID-19 pandemic continues, the latest evidence-based information must be provided to hemodialysis patients to promote self-care and prevention behavior that encourages ASB and discourages DSB.

Health knowledge, health behaviors and attitudes during pandemic emergencies: A systematic review

BACKGROUND

People with good health knowledge present a conceptual and objective appropriation of general and specific health topics, increasing their probability to express health protection and prevention measures. The main objective of this study was to conduct a rapid systematic review about the effects of health knowledge on the adoption of health behaviors and attitudes in populations under pandemic emergencies.

METHODS

A systematic review was performed according to PRISMA checklist and the Cochrane method for rapid systematic reviews. Studies searches were performed in APA PsycNet, Embase, Cochrane Library and PubMed Central. Studies published between January 2009 and June 2020 and whose primary results reported a measure of interaction between health knowledge, health attitudes and behaviors in population groups during pandemics were included. A review protocol was recorded in PROSPERO (CRD42020183347).

RESULTS

Out of a total of 5791 studies identified in the databases, 13 met the inclusion criteria. The included studies contain a population of 26099 adults, grouped into cohorts of health workers, university students, clinical patients, and the general population. Health knowledge has an important influence on the adoption of health behaviors and attitudes in pandemic contexts.

CONCLUSIONS

The consolidation of these preventive measures favors the consolidation of public rapid responses to infection outbreaks. Findings of this review indicate that health knowledge notably favors adoption of health behaviors and practices. Therefore, health knowledge based on clear and objective information would help them understand and adopt rapid responses to face a pandemic.

Exploring the predictors of health-protective behavior during the COVID-19 pandemic: A multi-country comparison

In recent years, examining the determinants of health behaviors on a multi-country level remains limited. Therefore, the purpose of this study is to explore the key factors that may enhance the adoption of health-protective behaviors during the COVID-19 pandemic in Morocco and India. A theoretical framework derived from the health belief model (HBM) was used for this research. Data was collected from a sample of 444 adult individuals split across Morocco (n = 215) and India (n = 229). Data analysis was carried out using two-stage multiple-analytic techniques. First, structural equation modeling (SEM) was employed to test the hypothesized relationships. Second, an artificial neural network (ANN) model was employed to rank the significant independent variables obtained from SEM analysis. The results of SEM showed that perceived benefit is the key predictor of the protective behavior in Morocco, followed by self-efficacy, and then perceived severity. By contrast, ANN analysis showed that perceived severity was the most vital factor for predicting the protective behavior in Morocco, followed by perceived benefits, and then self-efficacy. For the Indian sample, both SEM analysis and the ANN model revealed that the impact of perceived susceptibility on the adoption of the protective measure is stronger than that of cues to action. Theoretical contributions and managerial implications are also discussed toward the end.

Science knowledge and trust in medicine affect individuals’ behavior in pandemic crises

In pandemic crises such as the COVID-19 pandemic, individuals’ behavior has a strong impact on epidemiological processes. Compliance with prevention guidelines, such as social distancing, is critical to avoid further spreading an infectious disease or to slow down its spread. However, some individuals also or instead engage in panic behavior, such as hoarding. We investigate how education prepares individuals to respond adequately by modelling the path from seeking information about COVID-19 to eventual behavior. Based on a sample of N = 1182 adult Americans, gathered at the pandemic’s onset (March 2020), we conclude that science knowledge helps individuals convert information into coronavirus knowledge. This knowledge then helps individuals avoid panic behavior. Individuals lacking coronavirus knowledge and science knowledge still comply with prevention guidelines when they have a general trust in medicine. Individuals lacking knowledge still follow prevention guidelines when they trust in medicine. Facilitating science knowledge and trust in science through education and targeted public health messaging are likely to be of fundamental importance for bringing crises such as the COVID-19 pandemic under control.

Self-Leadership and Psychological Capital as Key Cognitive Resources for Shaping Health-Protective Behaviors during the COVID-19 Pandemic

As COVID-19 has become a global pandemic, health researchers and practitioners have focused attention on identifying the factors that may help to shape health-protective behaviors, protecting individual health and well-being, and helping to mitigate the spread of COVID-19. This study explores the potential role of self-leadership and psychological capital (PsyCap) as key cognitive resources for shaping health-protective behaviors. Using multiple theoretical frameworks (social cognitive theory, psychological resources theory, and the health belief model), this paper develops and tests a hypothesized serial mediation model in which PsyCap and coping self-efficacy mediate the relationship between self-leadership and health-protective behaviors including hand washing, wearing face masks, and social distancing. Results suggest that PsyCap and coping self-efficacy mediate the positive relationship between self-leadership and health-protective behaviors. These results yield valuable insights regarding the usefulness of self-leadership and PsyCap as cognitive resources for shaping health-protective behaviors and for possible self-leadership and PsyCap interventions, potentially tailored to at-risk populations, which should have practical benefits for both the current and future pandemics and health crises.

COVID-19 precautionary behavior among Israeli breast cancer patients

Objective

Cumulative knowledge indicates that cancer patients, among them breast cancer patients, are more susceptible to COVID-19 than individuals without cancer. Therefore, these patients need to take additional precautions against the COVID-19 outbreak. This study aimed to examine factors associated with precautionary behavior among Israeli breast cancer patients during the COVID-19 pandemic.

Methods

A cross-sectional study was conducted among 151 women with breast cancer. Participants completed measures of knowledge about COVID-19, perceived threat, sense of mastery, social support, precautionary behavior, and socio-demographic questionnaires. A multivariate regression model was calculated with precautionary behavior as the dependent variable.

Results

The mean of precautionary behavior score was relatively high. Participants perceived their health as relatively good, had relatively high knowledge about COVID-19, and moderate perceived threat. Sense of mastery was relatively moderate and perceived social support was relatively high. In the multivariate regression analysis, after controlling for the background variables, knowledge about COVID-19 (F(2,149) = 8.68, p < 0.001; beta = 0.36) was significantly associated with precautionary behavior. This variable explained 15.4% of the precautionary behavior variance.

Conclusion

Findings suggest that in order to enhance precautionary behavior among women with breast cancer during a pandemic outbreak, it is recommended to pay attention their knowledge about the virus.

COVID-19 Knowledge, Risk Perception, and Precautionary Behavior Among Nigerians: A Moderated Mediation Approach

The novel coronavirus has not only brought along disruptions to daily socio-economic activities, but sickness and deaths due to its high contagion. With no widely acceptable pharmaceutical cure, the best form of prevention may be precautionary measures which will guide against infections and curb the spread of the disease. This study explored the relationship between COVID-19 knowledge, risk perception, and precautionary behavior among Nigerians. The study also sought to determine whether this relationship differed for men and women. A web-based cross-sectional design approach was used to recruit 1,554 participants (mean age = 27.43, SD = 9.75; 42.7% females) from all geopolitical zones in Nigeria, through social media platforms using a snowball sampling technique. Participants responded to web-based survey forms comprising demographic questions and adapted versions of the Ebola knowledge scale, SARS risk perception scale, and precautionary behavior scale. Moderated mediation analysis of the data showed that risk perception mediated the association between COVID-19 knowledge and precautionary behavior and this indirect effect was in turn moderated by gender. Results indicate that having adequate knowledge of COVID-19 was linked to higher involvement in precautionary behavior through risk perception for females but not for males. It was also noted that awareness campaigns and psychological intervention strategies on COVID-19 related activities may be particularly important for males more than females. Drawing from the health belief model, we recommend that COVID-19 awareness campaigns should target raising more awareness of the risks associated with the infection to make individuals engage more in precautionary behaviors.

Comparing the knowledge gap hypothesis in the United States and Singapore: The case of nanotechnology

This study examines the knowledge gap hypothesis in the United States and Singapore in the context of nanotechnology. This study proposes that academic discipline serves as a better indicator than education levels in predicting nanotechnology knowledge gaps. To reflect the contemporary media landscape, this study examines how attention to online media and documentaries alongside traditional news outlets affect individuals' nanotechnology knowledge. In both countries, online media and documentaries, as well as traditional news outlets, were related to nanotechnology knowledge to various extents. While the knowledge gap hypothesis was not observed in Singapore, results revealed that increased media attention and interpersonal discussion widened knowledge gaps between individuals from science and non-science disciplines in the United States. Education levels failed to reveal a consistent moderation effect. Taken together, the interaction analyses revealed that academic discipline predicted nanotechnology knowledge gaps more consistently than education levels in the United States. Theoretical and practical implications are discussed.

A Moderated Mediation Model of the Relationship between Media, Social Capital, and Cancer Knowledge

We combined insights from various theories and models of media learning, and advanced an indirect model accounting for the mechanisms underlying the media influences on knowledge acquisition. Our model was largely supported by the data from a two-wave longitudinal panel survey with a nationwide sample of Korean adults. It was found that both personal cancer history and cancer worry were positively associated with exposure to stomach cancer information from the media. In turn, exposure to media information was positively related to reflective integration of that information, which ultimately leads to stomach cancer knowledge only among people with high levels of social capital. These findings suggest that media uses and effects are not only an individual but also a contextually dependent experience.

New channels, new ways of becoming informed? Examining the acquisition of public affairs knowledge by young people in China

People always rely on a specific media environment to acquire knowledge about public affairs. This pilot study investigates gain of public affairs knowledge as an effect of media use and interpersonal discussion in China. Based on a contextual understanding of China’s press system, this study explores the mainstream and alternative forms of public affairs knowledge and the ways they are linked with use of new media (i.e., web news and social media) and traditional media (i.e., newspaper and television). An analysis of survey data first shows that television news and web news have direct positive effects on mainstream knowledge, and only web news directly contributes to alternative knowledge. Second, news from newspapers, television, the web and social media have indirect effects on both mainstream and alternative forms of public affairs knowledge through elaboration and interpersonal discussion. Third, elaboration is only associated with alternative knowledge, whereas interpersonal discussion is associated with both mainstream and alternative knowledge. Theoretical and practical implications of the findings are discussed.

Risk salience of a novel virus: US population risk perception, knowledge, and receptivity to public health interventions regarding the Zika virus prior to local transmission

BACKGROUND

As the incidence of Zika infection accelerated in Central and South American countries from November 2015 through April 2016, U.S. public health officials developed vector control and risk communication strategies to address mosquito-borne and sexual modes of transmission. This study reports upon U.S. perceptions of the Zika virus prior to domestic transmission, and analyzes the association of socio-economic, political, knowledge and risk factors with population receptivity to selected behavioral, environmental, and clinical intervention strategies.

METHODS

A representative sample of 1,233 U.S. residents was drawn from address-based telephone and mobile phone lists, including an oversample of 208 women of child-bearing age living in five U.S. southern states. Data were collected between April and June, 2016, and weighted to represent U.S. population distributions.

RESULTS

Overall, 78% of the U.S. population was aware of Zika prior to domestic transmission. Those unaware of the novel virus were more likely to be younger, lower income, and of Hispanic ethnicity. Among those aware of Zika, over half would delay pregnancy for a year or more in response to public health warnings; approximately one third agreed with a possible vector-control strategy of targeted indoor spraying by the government; and nearly two-thirds agreed that the government should make pregnancy-termination services available to women who learn their fetus had a Zika-related birth defect. Receptivity to these public health interventions varied by age, risk perception, and knowledge of the virus.

CONCLUSION

Risk salience and population receptivity to public health interventions targeting a novel virus can be conditioned on pre-existing characteristics in the event of an emerging infectious disease. Risk communicators should consider targeted strategies to encourage adoption of behavioral, environmental, and clinical interventions.

Examining How Communication and Knowledge Relate to Singaporean Youths' Perceived Risk of Haze and Intentions to Take Preventive Behaviors

As Southeast Asia has experienced haze crises in recent years, encouraging Singaporeans to take preventive measures against negative health outcomes during haze is a growing concern. This study examines how communication factors (i.e., attention to traditional media and new media, interpersonal discussion, and knowledge) can inform Singaporeans about haze and influence their risk perceptions and intentions to undertake self-protective measures. The web survey of 410 respondents shows that attention to traditional media, attention to new media, interpersonal discussion, knowledge, and risk perception are positively associated with intention to take preventive measures. However, only interpersonal discussion is related to risk perception. Theoretical as well as practical implications of the findings are discussed.

How do readers choose to undergo treatments based on medical articles?

The purpose of this study is to study the reader's cognitive process in reading medical articles and its influence on the decision-making process. Twenty-four participants completed a survey pertaining to 36 medical articles on new treatments with similar text structures and similar titles. Participants rated each article on its level of interest, informativeness, and reliability, and were asked whether they would choose the treatments in the news article. A cognitive decision-making model can be applied to health contexts, in which the reader's subjective ratings on interest, informativeness, and reliability were positively associated with choosing new treatments. The decision-making process path from the perception of informativeness was mediated by the reliability of the news article. Interest was positively linked to informativeness, although it was not directly associated with reliability. This study shows that readers' subjective ratings on health information can indicate their decision-making. Artifacts in the information that might incite emotions or interest, such as framing, can affect the reader's decision-making process.

Behavioral Recommendations in Health Research News as Cues to Action: Self-Relevancy and Self-Efficacy Processes

This study argues that behavioral recommendations in health news function as cues to action. A proposed self-oriented model seeks to explore the impacts of behavioral recommendations in health research news as cues to action through their influences on self-relevancy and self-efficacy. A content analysis (Study 1) first establishes that health research news commonly features behavioral recommendations. A message experiment (Study 2) then explores the utility of behavioral recommendations as cues to action by demonstrating a self-relevancy effect: Health research news with, as opposed to without, behavioral recommendations increases the self-relevancy of advocated health behaviors, which then improve people's attitudes toward and intentions to adopt those behaviors. A second message experiment (Study 3) tests whether varying presentations of behavioral recommendations alter their effectiveness as cues to action and thus people's behavioral intentions through a dual effect process. In addition to the previously demonstrated self-relevancy effect, this experiment shows that concrete, as opposed to abstract, behavioral recommendations trigger a self-efficacy effect, increasing perceived self-efficacy and further improving behavioral intentions.

The Augmented Cognitive Mediation Model: Examining Antecedents of Factual and Structural Breast Cancer Knowledge Among Singaporean Women

As knowledge acquisition is an important component of health communication research, this study examines factors associated with Singaporean women's breast cancer knowledge using an augmented cognitive mediation model. We conducted a nationally representative study that surveyed 802 women between the ages of 30 and 70 using random-digit dialing. The results supported the augmented cognitive mediation model, which proposes the inclusion of risk perception as a motivator of health information seeking and structural knowledge as an additional knowledge dimension. There was adequate support for the hypothesized paths in the model. Risk perception was positively associated with attention to newspaper, television, Internet, and interpersonal communication. Attention to the three media channels was associated with interpersonal communication, but only newspaper and television attention were associated with elaboration. Interpersonal communication was positively associated with structural knowledge, whereas elaboration was associated with both factual and structural knowledge. Differential indirect effects between media attention and knowledge dimensions via interpersonal communication and elaboration were found. Theoretical and practical implications are discussed.

Theorizing the Pathways From Seeking and Scanning to Mammography Screening

This study combines insights from existing theories in mass communication and health communication, and builds an integrated model accounting for the mechanisms by which an individual's acquisition of mammogram-related media information becomes associated with intentions to obtain a mammogram. Our model was largely supported by a survey with a nationally representative sample of American females between the ages of 40 and 70 years. As expected, seeking and scanning mammogram-related information from the media were both positively associated with reflective integration of media health information, which in turn was positively related to behavioral attitudes and perceived normative pressures. Attitudes and normative pressures were then positively linked to the intention to get a mammogram. Based on these findings, we offer some suggestions for future research in this area.

Information scanning and vaccine safety concerns among African American, Mexican American, and non-Hispanic White women

OBJECTIVE

A significant number of parents delay or refuse vaccinating their children. Incidental exposure to vaccine information (i.e., scanned information) may be an important contributor to anti-vaccine sentiment. This study examines the association between scanned information, trust in health information sources and vaccine safety concerns among African American, Mexican American, and non-Hispanic White women.

METHODS

Women (N=761) in Los Angeles County were sampled via random digit dial and surveyed regarding use of and trust in health information resources and vaccine safety concerns.

RESULTS

Analyses indicate that the sources of information associated with vaccine safety concerns varied by ethnicity. Each ethnic group exhibited different patterns of association between trust in health information resources and vaccine safety concerns.

CONCLUSIONS

Information scanning is associated with beliefs about vaccine safety, which may lead parents to refuse or delay vaccinating their children. These relationships vary by ethnicity.

PRACTICE IMPLICATIONS

These findings help inform practitioners and policy makers about communication factors that influence vaccine safety concerns. Knowing these sources of information will equip practitioners to better identify women who may have been exposed to anti-vaccine messages and counter these beliefs with effective, vaccine-promoting messages via the most relevant information sources.