Longitudinal Risk Communication: A Research Agenda for Communicating in a Pandemic

Understanding the Risk of Social Vulnerability for the Chinese Diaspora during the COVID-19 Pandemic: A Model Driving Risk Perception and Threat Appraisal of Risk Communication-A Qualitative Study

During the first wave of the COVID-19 pandemic, immigrants were among the most socially vulnerable in Western countries. The Chinese diaspora in Canada were one such group due to the widespread cultural stigma surrounding their purported greater susceptibility to transmit and become infected by COVID-19. This paper aims to understand the social vulnerability of the Chinese diaspora in the Greater Toronto Area, Canada, during the first wave of COVID-19 from an explanation of their risk perception and threat appraisal of risk communication. We conducted secondary data analysis of 36 interviews using critical realism. The participants self-identified as being of Chinese descent. The results were used to develop a model of how social vulnerability occurred. In brief, cognitive dissonance was discovered to generate conflicts of one's cultural identity, shaped by social structures of (i) stigma of contagion, (ii) ethnic stigma, and (iii) public sentiment, and mediated by participants' threat appraisal and (iv) self-reliance. We assert that risk communicators need to consider their audiences' diverse socialization in crafting messages to modify behaviors, create a sense of responsibility, and mitigate public health threats. A lack of awareness of one's cognitive dissonance driven by cultural vulnerability may heighten their social vulnerability and prevent them from taking action to protect themself from high-risk events.

Individualism, economic development, and democracy as determinants of COVID-19 risk information on 132 government websites

Little is known about how governments transparently communicate about COVID-19. This study conducted a content analysis of 132 government COVID-19 websites to identify the salience of health messages (i.e., perceived threat, perceived efficacy, and perceived resilience) and cross-national determinants of information provision. Multinomial logistic regression was used to estimate the relationship between country-level predictors (i.e., economic development, democracy scores, and individualism index) and information salience. The numbers of deaths, discharged patients, and daily new cases were prevalent on the main webpages. Subpages provided information about vulnerability statistics, government responses, and vaccination rates. Less than 10% of governments included messages that may instill self-efficacy. Democratic countries had higher chances of providing threat statistics on subpages, including daily new cases (Relative Risk Ratio, RRR = 1.66, 95% CI: 1.16-2.37), mortalities (RRR = 1.69, 95% CI: 1.23-2.33), hospitalizations (RRR = 1.63, 95% CI: 1.12-2.37), and positivity rates (RRR = 1.55, 95% CI: 1.07-2.23). On subpages, democratic governments emphasized information about perceived vulnerability (RRR = 2.36, 95% CI: 1.50-3.73), perceived response efficacy (RRR = 1.48, 95% CI: 1.06-2.06), recovery numbers (RRR = 1.84, 95% CI: 1.31-2.60), and vaccinations (RRR = 2.14, 95% CI: 1.39-3.30). Developed countries reported the number of daily new cases, perceived response efficacy, and vaccination rates on their COVID-19 main pages. Individualism scores predicted the salience of vaccination rates on main pages and the omission of information related to perceived severity and perceived vulnerability. Democracy levels were more predictive of reporting information about perceived severity, perceived response efficacy, and perceived resilience on subpages of dedicated websites. Improving public health agencies' communication about COVID-19 is warranted.

COVID-19 Message Fatigue: How Does It Predict Preventive Behavioral Intentions and What Types of Information are People Tired of Hearing About?

This study examines the impact of message fatigue and what makes people fatigued in the context of the COVID-19 pandemic. Data collected with a Qualtrics panel (N = 744) showed that both active (i.e., reactance) and passive (i.e., inattention) resistance in message processing mediated the relationships between message fatigue and intentions to follow three types of preventive behaviors against COVID-19 (i.e., wearing masks, social distancing, and washing hands). The indirect effect of message fatigue on intention to seek COVID-19 information was explained by inattention but not reactance. Analyses of open-ended responses identified 18 types of COVID-related information that individuals were tired of hearing about. About 73.38% of participants (n = 546) reported that they were tired of hearing about at least one type of information about COVID-19, with mask-wearing being the most frequently mentioned (21.91%). The results extend existing research on message fatigue-evoked resistance to persuasion and provide practical implications for public health message design.

Scaling up the discovery of hesitancy profiles by identifying the framing of beliefs towards vaccine confidence in Twitter discourse

Our study focused on the discovery of how vaccine hesitancy is framed in Twitter discourse, allowing us to recognize at-scale all tweets that evoke any of the hesitancy framings as well as the stance of the tweet authors towards the frame. By categorizing the hesitancy framings that propagate misinformation, address issues of trust in vaccines, or highlight moral issues or civil rights, we were able to empirically recognize their ontological commitments. Ontological commitments of vaccine hesitancy framings couples with the stance of tweet authors allowed us to identify hesitancy profiles for two most controversial yet effective and underutilized vaccines for which there remains substantial reluctance among the public: the Human Papillomavirus and the COVID-19 vaccines. The discovered hesitancy profiles inform public health messaging approaches to effectively reach Twitter users with promise to shift or bolster vaccine attitudes.

Talking about health: Community ambassadors as a health promotion strategy to increase breast and bowel cancer screening in regional Australia

ISSUE ADDRESSED

In Australia, cancer is the leading contributor to disease burden, with breast and bowel cancer among the most commonly diagnosed cancers. Despite the presence of community-wide health promotion activities and screening programs, people living in regional and rural locations experience a number of factors that reduce breast and bowel cancer survival outcomes. This study investigates the ways that high-risk community members in a regional area of Australia interact with health messaging about breast and bowel cancer screening.

METHODS

A qualitative research method was used to conduct 31 in-depth one-on-one interviews with community members, leaders and essential service providers. A thematic approach was used to analyse data.

RESULTS

Findings provided insight to the ways that health is spoken about within the community, what prompts discussion of health, trustworthy sources of health information and the significance of peer-to-peer communication.

CONCLUSIONS

Existing community communication lines can be used to assist in delivering public health messages among high-risk and vulnerable population groups. Utilising community ambassadors is identified as a health promotion method for hard-to-reach populations. SO WHAT?: Conversations about health and screening amongst community members, and led by community members, play a key role in shaping engagement with cancer screening programs and represent an important site for health promotion activities. These findings have implications for future public health initiatives amongst high-risk groups in regional locations.

Influencing Factors and Symbiotic Mechanism of the Integration of Medical Care and Disease Prevention during the COVID-19 Pandemic: A Cross-Sectional Survey of Public Hospital Employees

Background: The COVID-19 outbreak has accelerated the huge difference between medical care and disease prevention in Chinese medical institutions. This study aimed to investigate the relationship between the symbiotic units, environments, models, and effects of the integration of medical care and disease prevention. Methods: This cross-sectional study involved 762 employees of public hospitals in 11 cities in Zhejiang Province by random stratified sampling. We analyzed the influence paths of elements in the mechanism of integration of medical care and disease prevention and the mediating effect of symbiotic models among symbiotic units, symbiotic environments, and effects on this integration. Results: The path coefficient of the symbiotic unit on the symbiosis model was 0.46 (p < 0.001), the path coefficient of the symbiotic environment on the symbiosis model was 0.52 (p < 0.001). The path coefficient of the symbiotic unit and the environment was 0.91 (p < 0.001). The symbiotic models exhibited a partial mediation effect between symbiotic units and the effect of this integration. Sobel test = 3.27, β = 0.152, and the mediating effect accounted for 34.6%. Conclusions: It is suggested that health policymakers and public hospital managers should provide sufficient symbiotic units, establish collaborative symbiotic models, and improve the effects of integration of medical care and disease prevention in public hospitals.

Visualizing the Knowledge Base and Research Hotspot of Public Health Emergency Management: A Science Mapping Analysis-Based Study

Public health emergency management has been one of the main challenges of social sustainable development since the beginning of the 21st century. Research on public health emergency management is becoming a common focus of scholars. In recent years, the literature associated with public health emergency management has grown rapidly, but few studies have used a bibliometric analysis and visualization approach to conduct deep mining and explore the characteristics of the public health emergency management research field. To better understand the present status and development of public health emergency management research, and to explore the knowledge base and research hotspots, the bibliometric method and science mapping technology were adopted to visually evaluate the knowledge structure and research trends in the field of public health emergency management studies. From 2000 to 2020, a total of 3723 papers related to public health emergency management research were collected from the Web of Science Core Collection as research data. The five main research directions formed are child prevention, mortality from public health events, public health emergency preparedness, public health emergency management, and coronavirus disease 2019 (COVID-19). The current research hotspots and frontiers are climate change, COVID-19 and related coronaviruses. Further research is needed to focus on the COVID-19 and related coronaviruses. This study intends to contribute inclusive support to related academia and industry in the aspects of public health emergency management and public safety research, as well as research hotspots and future research directions.

The Expert Next Door: Interactions With Friends and Family During the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic thrust the field of public health into the spotlight. For many epidemiologists, biostatisticians, and other public health professionals, this caused the professional aspects of our lives to collide with the personal, as friends and family reached out with concerns and questions. Learning how to navigate this space was new for many and required refining our communication depending on context, setting, and audience. Some of us took to social media, utilizing our existing personal accounts to share information after sorting through and summarizing the rapidly emerging literature to keep loved ones safe. However, those in our lives sometimes asked unanswerable questions, or began distancing themselves when we suggested more stringent guidance than they hoped, causing additional stress during an already traumatic time. We often had to remind ourselves that we are also individuals experiencing this pandemic, and that our time-intensive efforts were meaningful, relevant, and impactful. As this pandemic and other public health crises continue, we encourage our discipline to consider how we can best use shared lessons from this period, and recognize that our professional knowledge, when used in our personal lives, can promote, protect, and bolster confidence in public health.

The role of government risk communication in public health emergencies: evidence from the COVID-19 pandemic

Purpose

During the COVID-19 pandemic, government risk communication to the public was among the critical works, as the governments had to fight two enemies at once: the pandemic itself and the infodemic surrounding the COVID-19. Government risk communication could provide the public with prompt and accurate information as well as eliminate fake news, rumors and misinformation, thereby raising the public’s knowledge and risk perception and, thus, shaping their compliance with the government’s advices and directives. The purpose of this paper is to examine the effects of government risk communication through mass media on the public’s knowledge, risk perception and compliance with safety measures during the COVID-19 pandemic.

Design/methodology/approach

The ordinary least square and probit regression models were used for analyzing data collected from citizens living in Vietnam during the COVID-19 social distancing.

Findings

The results of this paper show that government risk communication enhances the public’s knowledge of the COVID-19 and raises their risk perception of the virus. In addition, government risk communication is found to shape the public’s compliance with most safety measures.

Practical implications

This paper offers practical implications for containing a pandemic (especially in the context that vaccines are unavailable or insufficient) by emphasizing the role of government risk communication.

Originality/value

This paper is among the first attempts that examine the role of government risk communication through mass media in enhancing the public’s knowledge, their risk perception and their compliance with safety measures during a pandemic.

Unmasking the Ethics of Public Health Messaging in a Pandemic

Uncertainty is inherent in new and unexpected viral outbreaks such as the current COVID-19 pandemic. It imposes challenges for health officials in soliciting cooperative behavioural changes based on incomplete information. In this paper, we use evolving mask recommendations in the United States as an example to analyse the ethical importance and practical demonstration of trustworthiness in pandemic messaging and decision-making. We argue that responsible public health interventions in the time of uncertainties requires explicit intersecting ethical considerations both in action and in communication to promote trustworthiness. First, as public health decisions have to be made in the face of incomplete and evolving data, health officials need to exhibit competence while committing to epistemic humility. They can explain the methods used in making and updating mask recommendations as well as explicitly acknowledge the need to incorporate sociocultural and other contextual considerations in translating scientific data into mask recommendations. Second, officials and agencies must uphold and communicate decisional transparency as part of their effort to demonstrate accountability and promote the public's understanding of the evolving pandemic. Third, especially since both the pandemic and mask recommendations may have disparate impact on different populations, officials should start with the fair implementation of the least restrictive measures that can help reduce harm.

Structural Racism and the COVID-19 Experience in the United States

The long, fallacious history of attributing racial disparities in public health outcomes to biological inferiority or poor decision making persists in contemporary conversations about the COVID-19 pandemic. Given the disproportionate impacts of this pandemic on communities of color, it is essential for scholars, practitioners, and policymakers to focus on how structural racism drives these disparate outcomes. In May and June 2020, we conducted a 6-state online survey to examine racial/ethnic differences in exposure to COVID-19, risk mitigation behaviors, risk perceptions, and COVID-19 impacts. Results show that Black and Hispanic individuals were more likely than White respondents to experience factors associated with structural racism (eg, living in larger households, going to work in person, using public transportation) that, by their very nature, increase the likelihood of exposure to COVID-19. Controlling for other demographic and socioeconomic characteristics, non-White respondents were equally or more likely than White respondents to take protective actions against COVID-19, including keeping distance from others and wearing masks. Black and Hispanic respondents also perceived higher risks of dying of the disease and of running out of money due to the pandemic, and 40% of Black respondents reported knowing someone who had died of COVID-19 at a time when the US death toll had just surpassed 100,000 people. To manage the current pandemic and prepare to combat future health crises in an effective, equitable, and antiracist manner, it is imperative to understand the structural factors perpetuating racial inequalities in the COVID-19 experience.