The Impact of Emotion and Government Trust on Individuals' Risk Information Seeking and Avoidance during the COVID-19 Pandemic: A Cross-country Comparison

What Encourages Patients to Recommend Their Doctor After an Online Medical Consultation? The Influence of Patient-Centered Communication, Trust, and Negative Health Information Seeking Experiences

The doctor-patient relationship in China has become increasingly tense, with patients lacking trust in doctors. Meanwhile, online healthcare flourished, accelerated by the COVID-19 pandemic. This study utilized the direct and indirect pathway model of clinician-patient communication to health outcomes and online trust theory to examine the associations between online patient-centered communication (OPCC), benevolence and ability trust in doctors, negative online health information seeking experiences, and willingness to recommend doctors. The findings revealed that benevolence and ability trust mediated the relationship between OPCC and willingness to recommend doctors. Additionally, when participants had a high level of negative online health information seeking experiences, OPCC had a stronger effect on ability trust; meanwhile, the mediation effect of ability trust between the relationship of OPCC and willingness to recommend was stronger. This study also discussed theoretical and practical implications.

Trends of fear and anger on YouTube during the initial stage of the COVID-19 outbreak in South Korea

BACKGROUND

The COVID-19 pandemic has been the most widespread and threatening health crisis experienced by the Korean society. Faced with an unprecedented threat to survival, society has been gripped by social fear and anger, questioning the culpability of this pandemic. This study explored the correlation between social cognitions and negative emotions and their changes in response to the severe events stemming from the COVID-19 pandemic in South Korea.

METHODS

The analysis was based on a cognitive-emotional model that links fear and anger to the social causes that trigger them and used discursive content from comments posted on YouTube's COVID-19-related videos. A total of 182,915 comments from 1,200 videos were collected between January and December 2020. We performed data analyses and visualizations using R, Netminer 4.0, and Gephi software and calculated Pearson's correlation coefficients between emotions.

RESULTS

YouTube videos were analyzed for keywords indicating cognitive assessments of major events related to COVID-19 and keywords indicating negative emotions. Eight topics were identified through topic modeling: causes and risks, perceptions of China, media and information, infection prevention rules, economic activity, school and infection, political leaders, and religion, politics, and infection. The correlation coefficient between fear and anger was 0.462 (p < .001), indicating a moderate linear relationship between the two emotions. Fear was the highest from January to March in the first year of the COVID-19 outbreak, while anger occurred before and after the outbreak, with fluctuations in both emotions during this period.

CONCLUSIONS

This study confirmed that social cognitions and negative emotions are intertwined in response to major events related to the COVID-19 pandemic, with each emotion varying individually rather than being ambiguously mixed. These findings could aid in developing social cognition-emotion-based public health strategies through education and communication during future pandemic outbreaks.

Considerations and challenges in support of science and communication of fish consumption advisories for per- and polyfluoroalkyl substances

Federal, state, tribal, or local entities in the United States issue fish consumption advisories (FCAs) as guidance for safer consumption of locally caught fish containing contaminants. Fish consumption advisories have been developed for commonly detected compounds such as mercury and polychlorinated biphenyls. The existing national guidance does not specifically address the unique challenges associated with bioaccumulation and consumption risk related to per- and polyfluoroalkyl substances (PFAS). As a result, several states have derived their own PFAS-related consumption guidelines, many of which focus on one frequently detected PFAS, known as perfluorooctane sulfonic acid (PFOS). However, there can be significant variation between tissue concentrations or trigger concentrations (TCs) of PFOS that support the individual state-issued FCAs. This variation in TCs can create challenges for risk assessors and risk communicators in their efforts to protect public health. The objective of this article is to review existing challenges, knowledge gaps, and needs related to issuing PFAS-related FCAs and to provide key considerations for the development of protective fish consumption guidance. The current state of the science and variability in FCA derivation, considerations for sampling and analytical methodologies, risk management, risk communication, and policy challenges are discussed. How to best address PFAS mixtures in the development of FCAs, in risk assessment, and establishment of effect thresholds remains a major challenge, as well as a source of uncertainty and scrutiny. This includes developments better elucidating toxicity factors, exposures to PFAS mixtures, community fish consumption behaviors, and evolving technology and analytical instrumentation, methods, and the associated detection limits. Given the evolving science and public interests informing PFAS-related FCAs, continued review and revision of FCA approaches and best practices are vital. Nonetheless, consistent, widely applicable, PFAS-specific approaches informing methods, critical concentration thresholds, and priority compounds may assist practitioners in PFAS-related FCA development and possibly reduce variability between states and jurisdictions. Integr Environ Assess Manag 2024;00:1-20. © 2024 SETAC.

Correlates of COVID-19 Information Overload and Information Seeking: Evidence from a Community Survey

PURPOSE

To examine the relationships among health literacy, risk perceptions, COVID-19 information overload, health information seeking, and race/ethnicity.

DESIGN

A cross-sectional non-probability community survey conducted between December 2020 and January 2021. A questionnaire was developed in collaboration with a local minority health task force.

SETTING

Albany, New York, USA.

SAMPLE

331 adults residing in Albany, NY and neighboring areas (80.3% completion rate).

MEASURES

Multi-item scales were used to measure health literacy, perceived severity, perceived susceptibility, information overload, and health information seeking frequency and types.

ANALYSIS

We conducted multivariate regression analysis.

RESULTS

Health literacy (standardized β = -.33, P < .001) and perceived severity (β = -.23, P < .001) were negatively associated with information overload. Information overload was negatively associated with health information seeking frequency (β = -.16, P < .05) and types (β = -.19, P < .01). A further analysis shows several factors, including information overload and race (African Americans), were negatively related to seeking specific types of information.

CONCLUSION

We find that low health literacy and perceived severity contribute to information overload and that information overload adversely affects health information seeking. Black individuals are less likely to search for certain types of information. The cross-sectional study design limits our ability to determine causality. Future research should employ panel data to determine the directionality of the observed relationships.

Understanding Social Media Information Sharing in Individuals with Depression: Insights from the Elaboration Likelihood Model and Schema Activation Theory

Purpose

How individuals engage with social media can significantly impact their psychological well-being. This study examines the impact of social media interactions on mental health, grounded in the frameworks of the Elaboration Likelihood Model and Schema Activation Theory. It aims to uncover behavioral differences in information sharing between the general population and individuals with depression, while also elucidating the psychological mechanisms underlying these disparities.

Methods

A pre-experiment (N=30) and three experiments (Experiment 1a N=200, Experiment 1b N=180, Experiment 2 N=128) were executed online. These experiments investigated the joint effects of information quality, content valence, self-referential processing, and depression level on the intention to share information. The research design incorporated within-subject and between-subject methods, utilizing SPSS and SPSS Process to conduct independent sample t-tests, two-factor ANOVA analyses, mediation analyses, and moderated mediation analyses to test our hypotheses.

Results

Information quality and content valence significantly influence sharing intention. In scenarios involving low-quality information, individuals with depression are more inclined to share negative emotional content compared to the general population, and this tendency intensifies with the severity of depression. Moreover, self-referential processing acts as a mediator between emotional content and intention to share, yet this mediation effect weakens as the severity of depression rises.

Conclusion

Our study highlights the importance of promoting viewpoint diversity and breaking the echo chamber effect in social media to improve the mental health of individuals with depression. To achieve this goal, tailoring emotional content on social media could be a practical starting point for practice.

Why do Chinese Youth Seek Cancer Risk Information Online? Evidence from Four Cities

This study, inspired by the Risk Information Seeking and Processing (RISP) model, examines the mechanisms by which perceived hazard characteristics and the informational subjective norms of Chinese youth, aged from 14 to 44 years old, become associated with their intentions to seek cancer risk information online. A sample of 684 Chinese youths was collected from four cities in Mainland China with results revealing that perceived hazard characteristics and informational subjective norms motivate their online cancer risk information seeking intentions. Specifically, perceived probability, perceived severity, and institutional trust are positively related to negative affect, however the relationship between personal control and negative affect is not significant. Institutional trust and personal control are positively related to positive affect while perceived probability and perceived severity have no significant effect on positive affect. Negative affect and informational subjective norms are positively related to perceived information insufficiency, while the relationship between positive affect and perceived information insufficiency is not significant. Negative affect, positive affect, informational subjective norms, and perceived information insufficiency are all positively related to the online cancer risk information seeking intentions of Chinese youth.

Risk Perception and Preventive Behavior During the COVID-19 Pandemic : Testing the Effects of Government Trust and Information Behaviors

Given the absence of COVID-19 treatments, the best way to control the spread of the virus is to break the chain of infection by increasing public participation in preventive behaviors recommended by health authorities. This study proposes a moderated mediation model of information behaviors (e.g. information seeking and information verification) and trust in government that explores the relationship between risk perception and preventive behaviors regarding COVID-19. Using a survey study in South Korea, we conducted the moderated mediation analysis with latent moderated structural equation modeling (LMS). We found serial mediation effects for risk perception, information behaviors, and preventive behaviors, as people both seek out information and verify that information before adopting preventive behaviors. Additionally, trust in government moderated information behaviors in the relationship between risk perception and preventive behaviors, suggesting that trust in government encourages people to adopt more preventive actions via information seeking and information verification. Further implications are discussed to promote public understanding of the health crisis and public participation in preventive measures.

A Cross-Country Analysis of the Combined Influence of Social Media Use and Perceived Social Media Networks on Pandemic Communicative Responses

This study examines how social media (SM) use is related to human responses to emerging infectious disease risks in the context of the COVID-19 pandemic via an online survey conducted in the United States and Taiwan. Results showed that SM use was related to different types of communicative responses (information seeking, interpersonal discussion, and rumor correction) directly and indirectly through cognitive and affective responses (risk perception, responsibility attribution, and negative and positive emotions). The indirect relationships between SM use and communicative responses through these cognitive and affective responses were moderated by perceived SM network structures. In particular, the mediating influence of negative emotions on communicative responses was associated with perceived SM network homogeneity, while that of positive emotions was related to perceived SM network centrality. Furthermore, responsibility attribution drove Taiwanese SM users' communicative responses, whereas the interrelated influence of positive emotions and perceived SM network centrality shaped American SM users' communicative responses.

Emotions on Twitter as crisis imprint in high-trust societies: Do ambient affiliations affect emotional expression during the pandemic?

During the Covid-19 crisis, citizens turned to Twitter for information seeking, emotional outlet and sense-making of the crisis, creating ad hoc social communities using crisis-specific hashtags. The theory of ambient affiliation posits that the use of hashtags upscales the call to affiliate with the values expressed in the tweet. Given the deep functional tie between values and emotions, hashtag use might further amplify certain emotions. While emotions in crises-hashtagged communities have been previously investigated, the hypothesis of amplification of emotions through hashtag use has not yet been tested. We investigate such effect during the Covid-19 crisis in a scenario of high-trust Nordic societies, focusing on non-hashtagged, crisis hashtagged (e.g., '#Covid-19') and threat hashtagged (e.g., '#misinformation') tweets. To do so we apply XLM-RoBERTa to estimate Anger, Fear, Sadness, Disgust, Joy and Optimism. Our results revealed that crisis-hashtagged (#Covid-19) tweets expressed more negative emotions (Anger, Fear, Disgust and Sadness) and less positive emotions (Optimism and Joy) than non-hashtagged Covid-19 tweets for all countries except Finland. Threat tweets (#misinformation) expressed even more negative emotions (Anger, Fear, Disgust) and less positive emotions (Optimism and Joy) than #Covid-19 tweets, with a particularly large effect for Anger. Our findings provide useful context for previous research on collective emotions during crises, as most Twitter content is not hashtagged, and given the faster spread of emotionally charged content, further support the special focus on specific ad hoc communities for crisis and threat management and monitoring.

PRISM and Emotions: Understanding the Role of Fear and Hope toward Vaccine Information Seeking Intentions

Vaccines represent one of the greatest health efforts to help combat diseases, yet they often evoke emotional responses among individuals. These emotional responses can influence an individual's desire to seek information about vaccines. The purpose of this research was to examine these relationships further using the Planned Risk Information Seeking Model (PRISM) and explore the role of emotions, specifically fear and hope, on vaccine-related information seeking intentions. Two separate models were tested using the PRISM model, one for fear and one for hope. Results suggest fear did not have a significant direct effect on vaccine information seeking, while hope had a positive and significant relationship. Interestingly, both attitude toward seeking and perceived current knowledge each had a positive relationship with information seeking intentions in the fear and hope models. Future research should continue to examine the role of specific emotions within the PRISM model to better predict information seeking intentions.

Reasons people avoid colorectal cancer information: a mixed-methods study

OBJECTIVE

With screening, colorectal cancer can be detected when treatable, or even prevented. However, approximately one in five people tend to avoid colorectal cancer information, and avoidance is associated with being less likely to have been screened for the disease. Crucial to developing strategies to reduce information avoidance, we sought a comprehensive understanding of reasons people avoid colorectal cancer information.

METHODS AND MEASURES

In a mixed methods study, we surveyed 200 participants who varied with respect to avoidance and interviewed 15 people who tended to avoid colorectal cancer information (all aged 40-75) about reasons for avoiding.

RESULTS

In both survey and interviews, primary reasons for information avoidance were: (1) shielding from anxiety and other aversive emotion, (2) perceived information sufficiency and (3) feelings of information overload. Trait anxiety, fear of diagnosis, anticipating negative interactions with healthcare, and negative associations with screening procedures exacerbated avoidance. Participants justified information non-relevance by attributing risk to other people's characteristics such as family history, gastrointestinal symptoms, being male, or living an unhealthy lifestyle.

CONCLUSION

Novel findings include the triggering influence of trait anxiety and financial constraints on information avoidance. Also, information overload and incorrect understanding of risk factors may exacerbate perceptions of information sufficiency and avoidance.

Information Avoidance: Past Perspectives and Future Directions

In the present age of unprecedented access to information, it is important to understand how and why people avoid information. Multiple definitions of "information avoidance" exist, and key aspects of these definitions deserve attention, such as distinguishing information avoidance from (lack of) information seeking, considering the intentionality and temporal nature of information avoidance, and considering the personal relevance of the information. In this review, we provide a cross-disciplinary historical account of theories and empirical research on information avoidance and seeking, drawing from research in multiple fields. We provide a framework of antecedents of information avoidance, categorized into beliefs about the information (e.g., risk perceptions), beliefs about oneself (e.g., coping resources), and social and situational factors (e.g., social norms), noting that constructs across categories overlap and are intertwined. We suggest that research is needed on both positive and negative consequences of information avoidance and on interventions to reduce information avoidance (when appropriate). Research is also needed to better understand temporal dynamics of information avoidance and how it manifests in everyday life. Finally, comprehensive theoretical models are needed that differentiate avoidance from seeking. Research on information avoidance is quickly expanding, and the topic will only grow in importance.

Information Seeking and Avoidance in the COVID-19 Pandemic as a Function of Political Ideology and National Context: A Survey Comparing the US and Germany

The COVID-19 pandemic sparked a globally heightened need for scientific information. At the same time, the abundance of information led to tendencies of media fatigue and information avoidance. Both information seeking and avoidance are embedded in a specific national context, in which conditions of and measures against the pandemic may differ dramatically. In addition, the pandemic quickly became entangled with political ideology. Using the Risk Information Seeking and Processing Model (RISP) as a theoretical background, we investigate the role of national context and political ideology for information seeking and avoidance in a comparative survey in the U.S. and Germany during the early phase of the pandemic. Results show that the factors predicting information behavior are effective in both countries with only few differences: In both countries, perceived hazard characteristics, information norms and perceived information gathering capacity were related to higher information seeking and lower information avoidance. Ideology too is an important influence: Right-leaning ideology was associated with lower levels of information norms in both countries; but only in the US was right-leaning ideology connected to less perceived hazard characteristics and less negative affective responses. Results are discussed regarding their implications for the RISP model.

Construction of influencing factors model for public information avoidance behavior in major infectious disease outbreaks based on meta-ethnography

Objective

Major infectious disease outbreaks are highly susceptible to diffuse outbreaks due to their sudden and more widespread nature. Compared to previous outbreaks such as the Spanish flu and SARS in China, COVID-19 has greatly affected the health of citizens and the economic development of countries worldwide, and is representative of major infectious disease outbreaks in many ways. Information avoidance, a common information behaviour during major infectious disease outbreaks, can alleviate the stress caused by information overload as a strategy to reduce negative emotions and maintain optimism. However, it can also bias risk perceptions and avoid content of greater value. Therefore, a deeper understanding of public information behaviour, particularly how and why relevant information is circumvented, places a demand on researchers.

Methods

A meta-ethnographic qualitative research methodology was used, and the seven steps of the methodology were strictly followed, including identifying integration themes, defining the connotations of integration themes, reading original studies, identifying relationships between studies, inter-translation between studies, synthetic translation, and presenting integration results. 26 original studies were integrated in a unified research framework, with a macro perspective that integrates consistent as well as complex and even contradictory findings and identifies dominant factors.

Conclusions

Identify demographic factors, information literacy, risk perception, cognitive structure, information quality, information sources, external characteristics of information, and environmental characteristics sub-dimensions around the dimensions of 'individual', 'information' and 'environment'. The study also explored the factors under each sub-dimension. The study finally identified three dimensions, nine sub-dimensions and 26 factors, and obtained a more complete theoretical framework to construct a "model of factors influencing public information avoidance behaviour in major infectious disease epidemics", with a view to providing a theoretical basis and practical reference for relevant departments in guiding public information behaviour and health practices in major infectious disease epidemics.

Avoiding Covid-19 risk information in the United States: The role of attitudes, norms, affect, social dominance orientations, and perceived trustworthiness of scientists

This study seeks guidance from the planned risk information avoidance model to explore drivers of risk information avoidance in the context of COVID-19. Data were collected early during the pandemic. Among our most notable results is that participants who are more oriented toward social dominance and are more skeptical of scientists' credibility have (1) more supportive attitudes toward risk information avoidance and (2) feel social pressure to avoid risk information. The findings of this study highlight how the role of skepticism in science and intergroup ideologies, such as social dominance, can have important implications for how people learn about health-related information, even in times of heightened crisis.

PFAS Contamination: Pathway from Communication to Behavioral Outcomes

ABSTRACTGuided by the risk information seeking and processing model, this study examines social cognitive variables that motivate individuals to actively seek and process information related to per- and polyfluoroalkyl substances (PFAS) contamination. Results indicate that information insufficiency, affective response, and informational subjective norms are positively related to information seeking and systematic processing, which are positively associated with policy support and intention to adopt risk mitigation behaviors. These findings suggest that when communicating the health risks of PFAS contamination to the general public, cognitive, affective, and normative factors are important initial steps to generate public interest in relevant information.

Information Avoidance in the Age of COVID-19: A Meta-Analysis

Guided by three major theoretical frameworks, this meta-analysis synthesizes 17 empirical studies (15 articles with 18,297 participants, 13 of them are from non-representative samples) and quantifies the effect sizes of a list of antecedents (e.g., cognitive, affective, and social factors) on information avoidance during the COVID-19 context. Findings indicated that information-related factors including channel belief (r = -.35, p < .01) and information overload (r = .23, p < .01) are more important in determining individual's avoidance behaviors toward COVID-19 information. Factors from the psychosocial aspects, however, had low correlations with information avoidance. While informational subjective norms released a negative correlation (r = -.16, p < .1) which was approaching significant, positive and negative risk responses were not associated with information avoidance. Moderator analysis further revealed that the impacts of several antecedents varied for people with different demographic characteristics (i.e., age, gender, region of origin), and under certain sampling methods. Theoretically, this meta-analysis may help determine the most dominant factors from a larger landscape, thus providing valuable directions to refine frameworks and approaches in health information behaviors. Findings from moderator analysis have also practically inspired certain audience segmentation strategies to tackle occurrence of information avoidance during the COVID-19 pandemic.

Modeling Electronic-Cigarette Users' Risk Information Avoidance

The current study examined e-cigarette users' risk information avoidance (i.e., RIA), which is a significant challenge to e-cigarette risk communication. Applying and extending previous RIA studies and the risk information seeking and processing (RISP) model, this study identified the predictors of e-cigarette users' RIA with a comprehensive model that incorporated new roles for scientific uncertainty and relevant channel beliefs. Responses collected from an online survey were analyzed (N = 593) and support was found for two pathways that explain e-cigarette users' motivation for RIA. One suggests heightened risk perceptions were associated with strong negative affective responses that include fear, anger, sadness, and guilt. These affective responses, in turn, were positively associated with RIA intentions. The second was a direct, positive association between scientific uncertainty and RIA as well as an indirect path mediated by relevant channel beliefs. More specifically, scientific uncertainty was negatively associated with quality perceptions of e-cigarette information making it more likely e-cigarette users would avoid it. Suggestions for how to prevent or mitigate these processes that result in e-cigarette users' maladaptive response of RIA are discussed.

The effect of cyberchondria on anxiety, depression and quality of life during COVID-19: the mediational role of obsessive-compulsive symptoms and Internet addiction

Since the global pandemic of the coronavirus disease 2019 (COVID-19), online health information-seeking behaviors have notably increased. Cyberchondria can be a vulnerability factor for the worsening of anxiety-depressive symptoms and quality of life. The current study aims to understand the predictive effect of cyberchondria on health anxiety, anxiety, depression and quality of life considering the mediating effect of obsessive-compulsive symptoms and Internet addiction and the moderating effect of COVID anxiety. 572 Italian participants (66% female; Mean age = 34; SD = 15) took part in a cross-sectional online survey involving CSS-12, MOCQ-R, IAT, SHAI, HADS, WHOQoL-BREF and CAS. Mediation and moderation analyses were conducted. Obsessive-compulsive symptoms and Internet addiction were found to partially mediate the cyberchondria-health anxiety and the cyberchondria-anxiety links and to totally mediate the cyberchondria-depression and the cyberchondria-quality of life links. COVID anxiety was found to moderate the relationship between cyberchondria and anxiety. The findings suggest that compulsivity may have a key role in the explanation of the underlying mechanisms of cyberchondria. Healthcare practitioners should provide additional support for individuals with cyberchondria. As such, cyberchondria is a contributing factor to the exacerbation of anxiety-depressive disorders and may impact on the quality of life.

Cognitive and Affective Routes to the Adoption of Protective Behaviors Against Health Risks of PM2.5 in China

The current research examines how risk appraisals of PM2.5 influence Chinese people's behavioral intentions to adopt government-recommended protective behaviors through negative affect. In testing the appraisal-based protective behavior model, this research also takes institutional trust and media sensationalism into account. An online survey is conducted with participants (N = 1,569) randomly drawn from heavily polluted Chinese regions. As predicted, negative affect mediates the effects of perceived susceptibility and perceived severity on individuals' intentions to take preventive measures against the PM2.5 risk. Institutional trust appears to increase people's behavioral intentions. However, media sensationalism decreases people's behavioral intentions.