Public Understanding of Ebola Risks: Mastering an Unfamiliar Threat

The direct effects of media exposure on behaviors aimed at preventing COVID-19 and its indirect effects as mediated by interpersonal communication: a longitudinal study in Japan

Objective

We aimed to examine the direct effects of exposure to media information about infection-preventing behavior and its indirect effects via interpersonal communication at two time points during the pandemic.

Methods

In August 2020 and August 2021, a web-based survey of Japanese people under a declared state of emergency was conducted. We collected sociodemographic data and data on seven types of exposure to media information, three types of exposure to interpersonal communication, and six types of infection-preventing behavior.

Results

A total of 784 participants completed both surveys. Exposure to information in the mass media decreased over the year, while interpersonal communication about COVID-19-related topics increased. The direct effect of exposure to information in the media about preventive behaviors was statistically significant in the pandemic's early stages, but this was no longer true after 1 year. The indirect effect via interpersonal communication was statistically significant at both time points.

Conclusion

Our results suggest that the influence of media information on infection-preventing behavior during the pandemic was maintained over time as an indirect effect via interpersonal communication. For risk communication media strategies during pandemics, adopting strategies to generate interpersonal communication will have a sustained effect on preventive behavior.

Mixed-methods study of university students' perceptions of COVID-19 and media consumption from March 2020 -April 2022

Longitudinal mixed-methods research is necessary to understand the changing dynamics of pandemic perceptions, the adoption of health behaviours, and use of media during a public health emergency. During the first two years of the COVID-19 pandemic, we used a mixed-methods approach to survey young adults attending a large Canadian public university. Six online convenience survey samples were collected (Spring 2020, Summer 2020, Fall 2020, Spring 2021, Fall 2021, Spring 2022) (n = 4932) and 110 semi-structured interviews were conducted. Female gender was associated with higher perceptions of severity, susceptibility, and the adoption of new health behaviours. Perceptions of severity and anxiety/fear about contracting COVID-19 after reading/hearing a news report decreased overall over time, while perceptions of susceptibility increased through time overall. Social media was the most used form of media and was the form of media that participants judged to make them feel most anxious/fearful about contracting COVID-19. Those who felt anxious after hearing a COVID-19 news report were 8.43 times more likely to judge COVID-19 as severe and 2.07 times more likely to judge their own susceptibility as high. Interviews revealed perceptions of information overload, passive information intake, and a narrowed geographical focus over time. The decrease in judgements of COVID-19 severity with the accompanying increase in judgements of susceptibility over the first two years of the pandemic demonstrate the dynamics of changing pandemic attitudes. Health communication efforts targeting university students in future major health events need to consider these shifting dynamics and ensure that health information distributed via social media meets the needs of university students.

Utilizing social media for community risk communication in megacities: analysing the impact of WeChat group information interaction and perception on communication satisfaction during the COVID-19 pandemic in Shanghai

BACKGROUND

Against the backdrop of the global public health crisis, the COVID-19 pandemic has exposed significant disparities in the supply and demand of risk information related to public health crises, posing severe challenges to risk governance in megacities. Shanghai, China, introduced community WeChat groups for community communication, effectively facilitating the dissemination and response of grassroots information and providing a new path for interactive governance in the community.

METHODS

This study collected 1006 questionnaires from residents of 350 communities in Shanghai through an online survey between June 10 and July 10, 2022. Multiple linear regression analysis was conducted to examine the impact of different participants (including the community, core residents, and the combined community and core residents) on community risk communication, perceived communication quality, and dissemination themes related to COVID-19 on community communication satisfaction. Additionally, in-depth interviews were conducted with 20 core residents from different types of communities, focusing on the specific methods of risk communication through community WeChat groups and their ability to disseminate information, respond to, and solve problems.

RESULTS

Perceived information coverage and perceived response efficiency are significantly positively correlated with communication satisfaction. Notably, the speed of community information response has the greatest impact on communication satisfaction. Regarding COVID-19-related information dissemination themes, "community outbreaks, supplies, nucleic acids, outbreak prevention measures, and scientific content" all have a significant impact on communication effectiveness, with "nucleic acid testing information" having the greatest impact. Although the statistical data indicate that the participation of core residents in risk communication does not significantly affect communication satisfaction, it seems to be related to the size of the community, and the interview results further validate this conclusion.

CONCLUSION

In the future, grassroots communities should consider the affordances of social media, recognize the significant correlation between risk communication and grassroots trust, and formulate more detailed and targeted risk communication strategies. In particular, incorporating core residents into "semiformal" grassroots organizations can improve community service quality, thereby enhancing community resilience in the face of public health emergencies.

A longitudinal investigation of risk perceptions and adaptation behavior in the US Gulf Coast

Climate change is occurring more rapidly than expected, requiring that people quickly and continually adapt to reduce human suffering. The reality is that climate change-related threats are unpredictable; thus, adaptive behavior must be continually performed even when threat saliency decreases (e.g. time has passed since climate-hazard exposure). Climate change-related threats are also intensifying; thus, new or more adaptive behaviors must be performed over time. Given the need to sustain climate change-related adaptation even when threat saliency decreases, it becomes essential to better understand how the relationship between risk perceptions and adaptation co-evolve over time. In this study, we present results from a probability-based representative sample of 2,774 Texas and Florida residents prospectively surveyed 5 times (2017-2022) in the presence and absence of exposure to tropical cyclones, a climate change-related threat. Distinct trajectories of personal risk perceptions emerged, with higher and more variable risk perceptions among the less educated and those living in Florida. Importantly, as tropical cyclone adaptation behaviors increased, personal risk perceptions decreased over time, particularly in the absence of storms, while future tropical cyclone risk perceptions remained constant. In sum, adapting occurs in response to current risk but may inhibit future action despite increasing future tropical cyclone risks. Our results suggest that programs and policies encouraging proactive adaptation investment may be warranted.

Contrasting Objective and Perceived Risk: Predicting COVID-19 Health Behaviors in a Nationally Representative U.S. Sample

BACKGROUND

Individuals confronting health threats may display an optimistic bias such that judgments of their risk for illness or death are unrealistically positive given their objective circumstances.

PURPOSE

We explored optimistic bias for health risks using k-means clustering in the context of COVID-19. We identified risk profiles using subjective and objective indicators of severity and susceptibility risk for COVID-19.

METHODS

Between 3/18/2020-4/18/2020, a national probability sample of 6,514 U.S. residents reported both their subjective risk perceptions (e.g., perceived likelihood of illness or death) and objective risk indices (e.g., age, weight, pre-existing conditions) of COVID-19-related susceptibility and severity, alongside other pandemic-related experiences. Six months later, a subsample (N = 5,661) completed a follow-up survey with questions about their frequency of engagement in recommended health protective behaviors (social distancing, mask wearing, risk behaviors, vaccination intentions).

RESULTS

The k-means clustering procedure identified five risk profiles in the Wave 1 sample; two of these demonstrated aspects of optimistic bias, representing almost 44% of the sample. In OLS regression models predicting health protective behavior adoption at Wave 2, clusters representing individuals with high perceived severity risk were most likely to report engagement in social distancing, but many individuals who were objectively at high risk for illness and death did not report engaging in self-protective behaviors.

CONCLUSIONS

Objective risk of disease severity only inconsistently predicted health protective behavior. Risk profiles may help identify groups that need more targeted interventions to increase their support for public health policy and health enhancing recommendations more broadly.

'COVID-19 is just another way to die…': a qualitative longitudinal study of frontline COVID-19 response governance across Syria

INTRODUCTION

Governance of COVID-19 responses has been challenging for all countries. Syria has been particularly challenged due to protracted multiparty conflict and debilitated health systems fragmented across different areas of control. To improve response governance, better understanding of frontline response policy implementation across the country is needed. This study thus explored perspectives of COVID-19 response governance among frontline healthcare providers over time and across major areas of control.

METHODS

We used a qualitative longitudinal study design, conducting five rounds of remote semistructured interviews in Arabic (ie, approximately eight interviews each in March 2020, July 2020, September 2020, December 2020 and September 2021) with 14 purposively sampled public and private healthcare providers in the three main areas of control (ie, opposition-controlled area, Autonomous Administration-controlled area and al-Assad government-controlled area (GCA)). We conducted integrative thematic analysis in Arabic within and across geography and time.

RESULTS

Almost all participants across all areas and rounds expressed distrust of local health authorities and dissatisfaction with COVID-19 response governance. This was most apparent in initial rounds and in GCA. Response planning was identified as insufficient, non-participatory and non-transparent. Limited infrastructure and resources were the main challenges across time, though anticipated rapid virus spread and health systems' collapse did not occur and participant optimism increased over time. Public adherence to prevention measures varied-initially weak due to general scepticism, increasing after first cases were confirmed and then fluctuating with case numbers and challenges of insecurity and misinformation. Perceptions of COVID-19 vaccination varied, with low uptake and hesitancy attributed to misinformation, disinformation and disinterest. Suggested improvements to COVID-19 response governance focused on strengthening health systems' capacity and coordination.

CONCLUSION

This is a unique longitudinal study of COVID-19 responses. Addressing transparency and misinformation should be a first step to improving public engagement and trust and thus response governance for health emergencies in Syria.

Association Between Pandemic Fatigue and Disease Knowledge, Attitudes, Concerns, and Vaccination Intention at Two Key Moments of the COVID-19 Pandemic

Objective: This study aimed to describe the change in knowledge, attitudes, concerns, perceptions, preventive practices, and vaccination intention at two key time points of the COVID-19 pandemic and to assess whether these changes varied by level of pandemic fatigue. Methods: Data included in this study came from the third and the ninth round of the COSMO-Spain cross-sectional study. A general linear model was used to investigate the interaction terms between rounds and levels of pandemic fatigue. Results: Changes between rounds were observed in knowledge, attitudes, concerns, perceptions, behaviours, and vaccination intention. Significant interactions between rounds indicated that those with low levels of pandemic fatigue had a greater increase in knowledge, lower decrease in concerns, greater decrease in agreement with the decisions made, and lower increase in vaccination intention compared with those with high pandemic fatigue. Conclusion: As a pandemic evolves, it becomes necessary to consider the level of pandemic fatigue of the population and how this affects knowledge, concerns, and agreement with the measures adopted, as they influence the population's adherence to public health recommendations aimed at controlling infections and protecting the most vulnerable.

A system dynamics model of the COVID-19 pandemic considering risk perception: A case study of Iran

The new coronavirus disease 2019 (COVID-19) has become a complex issue around the world. As the disease advancing and death rates are continuously increasing, governments are trying to control the situation by implementing different response policies. In order to implement appropriate policies, we need to consider the behavior of the people. Risk perception (RP) is a critical component in many health behavior change theories studies. People's RP can shape their behavior. This research presents a system dynamics (SD) model of the COVID-19 outbreak considering RP. The proposed model considers effective factors on RP, including different media types, awareness, and public acceptable death rate. In addition, the simplifying assumption of permanent immunity due to infection has been eliminated, and reinfection is considered; thus, different waves of the pandemic have been simulated. Using the presented model, the trend of advancing and death rates due to the COVID-19 pandemic in Iran can be predicted. Some policies are proposed for pandemic management. Policies are categorized as the capacity of hospitals, preventive behaviors, and accepted death rate. The results show that the proposed policies are effective. In this case, reducing the accepted death rate was the most effective policy to manage the pandemics. About 20% reduction in the accepted death rate causes about 23% reduction in cumulative death and delays at epidemic peak. The mean daily error in predicting the death rate is less than 10%.

What Drives People Away from COVID-19 Information?: Uncovering the Influences of Personal Networks on Information Avoidance

The pervasive of COVID-19 information has driven some to escape daily conversations or media coverage. A rich set of theoretical discussions and empirical studies help explain why individuals avoid health risk information, but few studies have explored social network antecedents to information avoidance. This study investigates how personal discussion networks about COVID-19 shape individuals' information avoidance behaviors. Using a nationally representative sample (N = 1,304), we examined the effects of network size, heterogeneity, ego-alter dissimilarity, and social norms. Our results suggest that the four network variables had varying effects on different forms of information avoidance. Notably, social norms significantly predicted individuals' information avoidance. The theoretical and methodological implications of our findings are discussed.

Communication Mechanisms and Implications of the COVID-19 Risk Event in Chinese Online Communities

Based on the context of communication and use of online communities in China, this study explored the characteristics and defects of risk communication of the government and official media in the event of COVID-19, as well as the factors that affected people's perception of the risk and protective behavior. The following results were found: (1) The government and official (mainstream) media accounts suffered from information lag in the early stage of COVID-19, while self-media accounts played the role of risk sensors, which caused people to have less trust in the government and the authorities and turn to the truth on self-media accounts. However, the low accessibility of self-media accounts and the imperfect check mechanism provided a hotbed for rumors, which further led to more fear and worry about risks. (2) During the middle and later periods of COVID-19, the government and the official media began to pay attention to the influence of self-media on peoples' emotions and behavior, and gradually improved the supervision of online information and the operation of official media accounts. This is intended to achieve information consistently and link mechanisms between official media and self-media to prevent and correct mistakes, as well as to achieve effective risk communication of information transparency, opinion exchange, and public sentiment stabilization.

Overexposure to COVID-19 information amplifies emotional distress: a latent moderated mediation model

An infodemic has accompanied the COVID-19 pandemic. This study explores whether overexposure to COVID-19-related information amplifies emotional distress. A cross-sectional online survey was conducted in China during the outbreak and after the peak of the pandemic (N = 1313). A latent moderated mediation model was built to analyze this relationship. COVID-19 information exposure was found to relate positively with emotional distress, and risk perception mediated the association between them. Additionally, psychological resilience moderated the mediating effects of risk perception. However, five factors of resilience differed in their moderating effects. This study offers theoretical and practical implications apropos clinical intervention and public health management.

Media exposure, risk perceptions, and fear: Americans' behavioral responses to the Ebola public health crisis

We examined media exposure, psychological fear and worry, perceptions of risk, and health protective behaviors surrounding the 2014 Ebola virus outbreak in a probability-based, representative, national sample of Americans (N = 3447). Structural equation models examined relationships between amount (hours/day) and content (e.g., graphic images of dead bodies) of media exposure and counts of self-reported health protective behaviors that participants performed or would perform if Ebola spread to their community. Ebola-related risk perceptions and fear and worry were potential mediators. Greater total hours and more graphic media exposure positively correlated with more fear and worry; greater total hours of media exposure also positively correlated with higher perceived risk. Higher risk perceptions were associated with more health protective behaviors performed and intended. Greater fear and worry were associated with more behaviors performed. Amount and content of media exposure exhibited indirect effects on behaviors performed; amount of media exposure had indirect effects on intentions. Media may help promote health protective behaviors during public health threats; the amount and content should be congruent with threat to minimize distress and maximize resources.

Stratified Impacts of the Infodemic During the COVID-19 Pandemic: Cross-sectional Survey in 6 Asian Jurisdictions

BACKGROUND

Although timely and accurate information during the COVID-19 pandemic is essential for containing the disease and reducing mental distress, an infodemic, which refers to an overabundance of information, may trigger unpleasant emotions and reduce compliance. Prior research has shown the negative consequences of an infodemic during the pandemic; however, we know less about which subpopulations are more exposed to the infodemic and are more vulnerable to the adverse psychological and behavioral effects.

OBJECTIVE

This study aimed to examine how sociodemographic factors and information-seeking behaviors affect the perceived information overload during the COVID-19 pandemic. We also investigated the effect of perceived information overload on psychological distress and protective behavior and analyzed the socioeconomic differences in the effects.

METHODS

The data for this study were obtained from a cross-national survey of residents in 6 jurisdictions in Asia in May 2020. The survey targeted residents aged 18 years or older. A probability-based quota sampling strategy was adopted to ensure that the selected samples matched the population's geographical and demographic characteristics released by the latest available census in each jurisdiction. The final sample included 10,063 respondents. Information overload about COVID-19 was measured by asking the respondents to what extent they feel overwhelmed by news related to COVID-19. The measure of psychological distress was adapted from the Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5). Protective behaviors included personal hygienic behavior and compliance with social distancing measures.

RESULTS

Younger respondents and women (b=0.20, 95% CI 0.14 to 0.26) were more likely to perceive information overload. Participants self-perceived as upper or upper-middle class (b=0.19, 95% CI 0.09 to 0.30) and those with full-time jobs (b=0.11, 95% CI 0.04 to 0.17) tended to perceive higher information overload. Respondents who more frequently sought COVID-19 information from newspapers (b=0.12, 95% CI 0.11 to 0.14), television (b=0.07, 95% CI 0.05 to 0.09), and family and friends (b=0.11, 95% CI 0.09 to 0.14) were more likely to feel overwhelmed. In contrast, obtaining COVID-19 information from online news outlets and social media was not associated with perceived information overload. There was a positive relationship between perceived information overload and psychological distress (b=2.18, 95% CI 2.09 to 2.26). Such an association was stronger among urban residents, full-time employees, and those living in privately owned housing. The effect of perceived information overload on protective behavior was not significant.

CONCLUSIONS

Our findings revealed that respondents who were younger, were female, had a higher socioeconomic status (SES), and had vulnerable populations in the household were more likely to feel overwhelmed by COVID-19 information. Perceived information overload tended to increase psychological distress, and people with higher SES were more vulnerable to this adverse psychological consequence. Effective policies and interventions should be promoted to target vulnerable populations who are more susceptible to the occurrence and negative psychological influence of perceived information overload.

The Moderating Role of Community Capacity for Age-friendly Communication in Mitigating Anxiety of Older Adults During the COVID-19 Infodemic: Cross-sectional Survey

Background

Older adults were perceived as a vulnerable group during the COVID-19 pandemic due to the health and mental health challenges they faced. The pandemic was accompanied by an “infodemic” of overabundant and questionable information that has affected older adults’ mental health. As the infodemic and ageist narratives were prevalent online, more anxiety symptoms have been induced among older adults who used social media. Age-friendly communication, advocated by the World Health Organization’s Age-friendly City (AFC) guide, could be an antidote by providing tailored information via appropriate channels for older adults.

Objective

This study investigated the role of community capacity for age-friendly communication in mitigating anxiety during the pandemic. We hypothesized that age-friendly communication would moderate the effects of infection risks and social media use on anxiety. A double-moderating effect was hypothesized in the context of diminished trust in traditional media.

Methods

Data were collected from a cross-sectional telephone survey conducted in Hong Kong in 2020. Older adults (N=3421, age≥60 years) were interviewed about their well-being and daily lives. Community capacity for age-friendly communication was measured in a living district–based evaluation. It had 2 components: the reach of appropriate information to older adults (AFC-Information) and the age-friendliness of communication technologies (AFC-Communication Technology) in the community. We tested the hypothesized moderation and double-moderation effects with ordinary least squares regressions.

Results

Perceived COVID-19 infection risk (b=0.002, P=.02) and use of social media for COVID-19 information (b=0.08, P=.04) were associated with more anxiety symptoms. The effect of using social media was moderated by AFC-Information (b=–0.39, P=.002) and AFC-Communication Technology (b=–1.06, P<.001), and the effect of perceived COVID-19 infection risk was moderated by AFC-Information (b=–0.03, P=.002) and AFC-Communication Technology (b=–0.05, P<.001). Lower trust in traditional media exacerbated anxiety symptoms associated with social media use (b=–0.08, P=.02). Higher AFC-Information alleviated this moderation effect (AFC-Information × media trust b=–0.65, P<.001; AFC-Information × social media use b=–2.18, P<.001; 3-way interaction b=0.40, P=.003).

Conclusions

Our findings highlight the role of community age-friendly communication in mitigating anxiety related to the infodemic. Although using social media may have exacerbated the impact of the infodemic on older adults, it has the potential to deliver timely information for an adequate health response. Although the amplifying effects of low media trust was associated with social media use, age-friendly communication determined its strength. Instead of discouraging the use of digital technologies for COVID-19 information, efforts should be made in tailoring information and communication technologies in local communities for older adults.

Testing the Effectiveness of the Health Belief Model in Predicting Preventive Behavior During the COVID-19 Pandemic: The Case of Romania and Italy

We use a cultural psychology approach to examine the relevance of the Health Belief Model (HBM) for predicting a variety of behaviors that had been recommended by health officials during the initial stages of the COVID-19 lockdown for containing the spread of the virus and not overburdening the health system in Europe. Our study is grounded in the assumption that health behavior is activated based on locally relevant perceptions of threats, susceptibility and benefits in engaging in protective behavior, which requires careful attention to how these perceptions might be structured and activated. We assess the validity of the HBM in two European countries that have been relatively understudied, using simultaneous measurements during acute periods of infection in Romania and Italy. An online questionnaire provided a total of (N = 1863) valid answers from both countries. First, to understand individual difference patterns within and across populations, we fit a General Linear Model in which endorsement was predicted by behavior, country, their interaction, and a random effect for participants. Second, we assess the effect of demographics and health beliefs on prevention behaviors by fitting a multi-group path model across countries, in which each behavior was predicted by the observed health belief variables and demographics. Health beliefs showed stronger relationships with the recommended behaviors than demographics. Confirming previously reported relationships, self-efficacy, perceived severity, and perceived benefits were consistently related to the greater adoption of individual behaviors, whereas greater perceived barriers were related to lower adoption of health behaviors. However, we also point to important location specific effects that suggest that local norms shape protective behavior in highly contextualized ways.

The role of online news and social media in preventive action in times of infodemic from a social capital perspective: The case of the COVID-19 pandemic in South Korea

Infodemic, the spread of false information during the COVID-19 pandemic, has been raised as one of the major concerns aggravating the confusion in the global society. In this regard, the role of media as an information channel in delivering the reliable information and motivating the active participation of citizens in complying with government's preventive actions becomes much more important. In this study, the role of online news and social media on people's preventive actions considering the role of trust in citizens and government from the perspective of social capital is investigated. For the empirical study, a structural equation modeling is employed by using survey material gathered from South Korea in the early days of the COVID-19 outbreak. South Korea was selected as its COVID-19 prevention strategy focused not only on the provision of medical support, but also on the enhancement of social trust through active engagement with people through media channels. Our results reveal that the perceived characteristics of online news and social media influence preventive actions through the trust in citizens or in government. In addition, while online news media enhances trust in both the citizens and the government, social media only influences trust in citizens. Based on our findings, the role of media in preventing the spread of COVID-19 is dicussed.

Race, Ethnicity, Nativity and Perceptions of Health Risk during the COVID-19 Pandemic in the US

Previous research demonstrates that pandemics, including COVID-19, have disproportionate effects on communities of color, further exacerbating existing healthcare inequities. While increasing evidence points to the greater threat posed by COVID-19 to Latinx communities, less remains known about how identification as Latinx and migration status influence their perception of risk and harm. In this article, we use cross-sectional data from a large national probability sample to demonstrate a large positive association between ethnic identity and migration status and perceptions of harm from COVID-19 in the US. We find that individuals identifying as Hispanic/Latinx and first-generation immigrants report significantly greater risks of becoming infected by COVID-19 in the next three months, and dying from the virus if they do contract it. Further, subgroup analysis reveals that health risks are especially felt by individuals of Mexican descent, who represent the largest share of US Latinxs. Collectively, our results provide evidence about how the pandemic places increased stress on people from Latinx and immigrant communities relative to White non-Hispanic individuals in the US.

The effect of information-seeking behaviours on prevention behaviour implementation during the COVID-19 pandemic: mediating effects of anxiety and fear

OBJECTIVES

Identifying determinants of prevention behaviours during the emergence of a new infectious disease is important. We investigated the associations between information-seeking and prevention behaviours during the coronavirus disease 2019 (COVID-19) pandemic and mediating effects of psychiatric factors.

METHODS

In total, 1,970 participants from the Cardiovascular and Metabolic Etiology Research Center cohort participated in an online survey 55 days after the first COVID-19 case in Korea was diagnosed. Time spent seeking information related to COVID-19; information sources; psychiatric factors, including anxiety, depression, post-traumatic stress symptoms (PTSS), and the fear of COVID-19; and prevention behaviours were examined. The mediating effect of psychiatric factors was estimated using mediation analysis.

RESULTS

Time spent seeking information and information sources affected several behavioural responses. In men, anxiety mediated associations between information-seeking and prevention behaviours, including purchasing sanitary supplies (effect size [ES], 0.038; 95% confidence interval [CI], 0.002 to 0.095) and hoarding (ES, 0.029; 95% CI, 0.002 to 0.068). The fear of COVID-19 also mediated associations between information-seeking and prevention behaviours including refraining from going out (men: ES, 0.034; 95% CI, 0.009 to 0.068; women: ES, 0.052; 95% CI, 0.030 to 0.080), wearing face masks (men: ES, 0.085; 95% CI, 0.031 to 0.184), avoiding public transportation (men: ES, 0.020; 95% CI, 0.000 to 0.044; women: ES, 0.031; 95% CI, 0.015 to 0.051), hoarding (women: ES, 0.051; 95% CI, 0.029 to 0.792), and trying alternative remedies (men: ES, 0.024; 95% CI, 0.004 to 0.053). Depressive symptoms and PTSS did not have any mediating effects.

CONCLUSIONS

While the availability of information related to COVID-19 can help prevent infections, it can also promote anxiety and fear, leading to negative behaviours such as hoarding and trying unverified alternative treatments.

Mechanism of WeChat's Impact on Public Risk Perception During COVID-19

PURPOSE

Taking COVID-19 as an example, this paper explores the mechanism of WeChat's impact on risk information transmission in social media and builds a model of WeChat's impact on public risk perception based on risk communication.

METHODS

Research primarily utilised the questionnaire survey method to collect and analyse public attitudes towards COVID-19 to achieve the research goals. We checked the adequacy of measurements and tested the hypotheses with regression analysis based on 801 participants in China.

RESULTS

The results indicated that the levels of the public WeChat COVID-19 risk information attention and trust had a significant positive impact on the public's risk perception and willingness of pandemic prevention. The improved public risk perception of COVID-19 as a mediator enhanced the public pandemic prevention ability, which allowed WeChat to play a more effective role in major disaster emergency.

Social media conversations reveal large psychological shifts caused by COVID-19's onset across U.S. cities

The current research chronicles the unfolding of the early psychological impacts of coronavirus disease 2019 (COVID-19) by analyzing Reddit language from 18 U.S. cities (200,000+ people) and large-scale survey data (11,000+ people). Large psychological shifts were found reflecting three distinct phases. When COVID-19 warnings first emerged (“warning phase”), people’s attentional focus switched to the impending threat. Anxiety levels surged, and positive emotion and anger dropped. In parallel, people’s thinking became more intuitive rather than analytic. When lockdowns began (“isolation phase”), analytic thinking dropped further. People became sadder, and their thinking reflected attempts to process the uncertainty. Familial ties strengthened, but ties to broader social groups weakened. Six weeks after COVID-19’s onset (“normalization phase”), people’s psychological states stabilized but remained elevated. Most psychological shifts were stronger when the threat of COVID-19 was greater. The magnitude of the observed shifts dwarfed responses to other events that occurred in the previous decade.

Infodemic vs. Pandemic Factors Associated to Public Anxiety in the Early Stage of the COVID-19 Outbreak: A Cross-Sectional Study in China

Introduction: Every outbreak of an epidemic or pandemic disease is accompanied by the tsunami of information, which is also known as the infodemic. Infodemic makes it hard for people to find trustworthy sources and reliable guidance when they need it, and causes social panic about health, widens the gaps between races and regions, and even brings the social chaos all over the world. While most researchers and related parties made efforts to control the inaccurate information spreading online during the COVID-19 pandemic, the infodemic influence caused by the overload of accurate information were almost or completely ignored, and this will hinder the control of infodemic in future public health crises. This study aims to explore the infodemic vs. pandemic influence on people's psychological anxiety across different media sources in the early stage of the COVID-19 outbreak in China. Methods: A cross-sectional study using online survey method was conducted by a data-collection service provider in April 2020. A total of 1,117 valid samples were finally collected from 5,203 randomly invited members via webpages and WeChat. The sample distribution covered the 30 provincial administrative divisions of mainland China. Results: Hierarchical regression analysis for the potential pandemic sources and infodemic sources of psychological anxiety showed that the infodemic factors of attention to the coronavirus information (β = 0.154, p < 0.001) and commercial media exposure (β = 0.147, p < 0.001) is positively related to the level of anxiety. Statistics indicated that influence of the infodemic factors is over and above that of the pandemic factors (ΔR ² = 0.054, F = 14.199, and p < 0.001). Mediation analysis showed that information overload (B = 0.155, Boot SE = 0.022, and 95% Boot CI [0.112, 0.198]) mediates the link between attention to coronavirus information and anxiety; both information overload (B = 0.035, Boot SE = 0.014, and 95% Boot CI [0.009, 0.062]) and media vicarious traumatization (B = 0.106, Boot SE = 0.017, and 95% Boot CI [0.072, 0.140]) mediate the link between commercial media exposure and anxiety. Conclusion: This study suggested that the influence of infodemic with mixed accurate and inaccurate information on public anxiety does exist, which could possibly go beyond that of the pandemic. Information overload and vicarious traumatization explain how infodemic may be associated to public anxiety. Finally, commercial media could be a major source of infodemic in the Chinese media context. Implications for the related parties were discussed.

How Does Risk-Information Communication Affect the Rebound of Online Public Opinion of Public Emergencies in China?

The rebound of online public opinion is an important driving force in inducing a secondary crisis in the case of public emergencies. Effective risk-information communication is an important means to manage online public opinion regarding emergencies. This paper employs fuzzy-set qualitative comparative analysis to discover which conditions are combined and may result in the rebound of online public opinion. Five conditions were selected: the type of public emergency, messengers, message attributes, audience, and information feedback. The study used a sample of 25 major public emergencies that occurred between 2015 and 2020 in China. The type of public emergency, audience, and information feedback emerged as critical influencing factors. Message attributes promote the rebound of online public opinion regarding public health emergencies, while messengers play a traction role in the rebound of online public opinion on other types of public emergencies. This study extends risk-information communication theory from the perspective of the type of emergency, explores the causes of rebounded online public opinion regarding public emergencies, and provides policies and suggestions for risk-information communication and online public-opinion governance during emergencies.

Levels of Trust in Information Sources as a Predictor of Protective Health Behaviors During COVID-19 Pandemic: A UAE Cross-Sectional Study

Health information sources and the level of trust in a particular source may influence the subsequent adoption of advocated health behaviors. Information source preference and levels of trust are also likely to be influenced by sociodemographic (culture, age, gender) variables. Understanding these source-trust-behavior relationships across various national and cultural contexts is integral to improved health messaging. The present study identified the sources most frequently consulted to obtain information about COVID-19 during the pandemic's early stages in the United Arab Emirates (UAE). The study quantified levels of trust across an array of information sources, factoring in sociodemographic variables. Finally, the study explored the relationship between sociodemographic variables, levels of trust in information sources, and the adoption of COVID-19 related protective behaviors. Participants (n = 1585) were recruited during the first 2 weeks of April 2020 via announcements in the UAE media and through email networks. All participants completed a web-based survey presented in English or Arabic, as preferred. The most frequently consulted information sources were websites (health information websites), social media, government communications, and family and friends. The sources rated most trustworthy were: personal physicians, health care professionals, and government communications. There were differences in the use of sources and levels of trust according to age, gender, and education. The levels of trust in sources of information were associated with the adoption of protective behaviors, significantly so for citizens of the UAE. These findings may help inform the improvement of pandemic-related health messaging in multicultural contexts.

The Impact of Trust and Risk Perception on the Acceptance of Measures to Reduce COVID-19 Cases

The SARS-CoV-2 virus that causes COVID-19 has had a large impact on the lives of many people worldwide. At the peak of confirmed COVID-19 cases during the first wave in Switzerland (March-April 2020), we conducted a survey in the German-speaking part of the country (N = 1,585). The results suggest that the implemented measures are accepted. The survey participants are more concerned that other family members could catch the virus compared with themselves, and they are worried about its economic impact. The results suggest that how trust is measured is crucial because general trust and social trust have opposite effects on the participants' risk perceptions. People with high general trust perceive less risks associated with COVID-19 compared with people who have low general trust, and people with high social trust perceive more risks compared with people who have low social trust. The results further indicate that perceived risks are important drivers for the acceptance of the government's implemented measures to control COVID-19 and for more precautionary behavior (i.e., contact with fewer people and more hygienic behavior). Theoretical and practical implications of these findings are discussed.

When public health messages become stressful: Managing chronic disease during COVID-19

To curb the spread of COVID-19, the United States has endorsed a variety of public health measures and distributed their content expediently. While these measures are critical for saving the lives of thousands, they may be sources of stress for individuals managing a chronic disease or make disease management more challenging. Forty-five percent of Americans live with chronic disease and already manage a range of everyday stressors related to their disease, making the additional stress produced by this public health guidance and their messages more difficult. Guided by Cohen and colleagues’ Stage Model of Stress and Disease (Cohen et al., 2016) and Ryan and Sawin’s Individual and Family Self-Management Theory (Ryan & Sawin, 2009), this paper identifies the various dimensions of these public health measures that may cause stress and negatively impact individuals managing chronic disease. Further, this paper presents a conceptual model for understanding how these stressors and common stressors associated with managing chronic disease interact and significantly impact chronic disease management. Considering the impact of these stressors on individuals managing chronic disease is paramount to ensure this population is empowered to manage this additional stress healthily and effectively. Recommendations for individuals managing chronic disease and health care professionals working with this population are provided.

Predicting the COVID-19 Pandemic: The Perceptions of Healthcare Workers and the General Public

BACKGROUND

Coronavirus Disease 2019 (COVID-19) is a pandemic of significant international concern, requiring decisive government actions with public understanding and subsequent adherence to control the spread. This study investigated the predictions of the public and healthcare workers (HCWs) at an early stage of the United Kingdom (UK) pandemic to assess their understanding of this novel virus and provide a reflection of the information readily available to them at the time.

METHOD

A cross-sectional survey between the 18th and 20th March 2020 of UK adults was conducted via an anonymous 17-question online questionnaire using a snowball sampling technique. Simple descriptive statistics, repeated measures analysis of variance (ANOVA), and unpaired Mann-Whitney t-tests investigated significance at the P<·05 levels.

RESULTS

A total of 823 UK residents responded, of which 12·0% (n=99) were HCWs (doctors and nurses). The primary information sources used by our participants were BBC News, group messaging such as WhatsApp, and NHS England. The majority (38·9%) estimated government-enacted social restrictions would last two to four weeks. Mean best guess of total UK COVID-19 mortality was 1000 to 10,000 deaths, and the majority of participants (77·9%) revealed that they expected their day-to-day lives to be affected for less than six months in total. HCWs consistently estimated greater duration, scale, and impact of COVID-19 than non-healthcare workers (Non-HCWs).

CONCLUSION

Survey respondents greatly underestimated the duration and impact of COVID-19 on their personal and public lives. Non-HCWs made greater underestimates than HCWs. This provides a historical reference and highlights a lack of clear information regarding the pandemic at the time of the survey. There is an ongoing need for effective, realistic, and timely communication between government, front-line clinicians, and the general public to manage expectations of the course of the pandemic and, consequently, increase adherence to public health measures.

Dealing With the COVID-19 Infodemic: Distress by Information, Information Avoidance, and Compliance With Preventive Measures

In the ongoing coronavirus disease 2019 (COVID-19) pandemic, media reports have caused anxiety and distress in many. In some individuals, feeling distressed by information may lead to avoidance of information, which has been shown to undermine compliance with preventive health behaviors in many health domains (e.g., cancer screenings). We set out to examine whether feeling distressed by information predicts higher avoidance of information about COVID-19 (avoidance hypothesis), and whether this, in turn, predicts worse compliance with measures intended to prevent the spread of COVID-19 (compliance hypothesis). Thus, we conducted an online survey with a convenience sample (N = 1,059, 79.4% female) and assessed distress by information, information avoidance, and compliance with preventive measures. Furthermore, we inquired about participants' information seeking behavior and media usage, their trust in information sources, and level of eHealth literacy, as well as generalized anxiety. We conducted multiple linear regression analyses to predict distress by information, information avoidance, and compliance with preventive measures. Overall, distress by information was associated with better compliance. However, distress was also linked with an increased tendency to avoid information (avoidance hypothesis), and this reduced compliance with preventive measures (compliance hypothesis). Thus, distress may generally induce adaptive behavior in support of crisis management, unless individuals respond to it by avoiding information. These findings provide insights into the consequences of distress by information and avoidance of information during a global health crisis. These results underscore that avoiding information is a maladaptive response to distress by information, which may ultimately interfere with effective crisis management. Consequently, we emphasize the need to develop measures to counteract information avoidance.

The Evolving Field of Risk Communication

The 40th Anniversary of the Society for Risk Analysis presents an apt time to step back and review the field of risk communication. In this review, we first evaluate recent debates over the field's current state and future directions. Our takeaway is that efforts to settle on a single, generic version of what constitutes risk communication will be less productive than an open-minded exploration of the multiple forms that comprise today's vibrant interdisciplinary field. We then review a selection of prominent cognitive, cultural, and social risk communication scholarship appearing in the published literature since 2010. Studies on trust in risk communication messengers continued to figure prominently, while new research directions emerged on the opportunities and critical challenges of enhancing transparency and using social media. Research on message attributes explored how conceptual insights particularly relating to framing, affective and emotional responses, and uncertainty might be operationalized to improve message effectiveness. Studies consistently demonstrated the importance of evaluation and how varying single attributes alone is unlikely to achieve desired results. Research on risk communication audiences advanced on risk perception and multiway engagement with notable interest in personal factors such as gender, race, age, and political orientation. We conclude by arguing that the field's interdisciplinary tradition should be further nurtured to drive the next evolutionary phase of risk communication research.

Susceptibility to misinformation about COVID-19 around the world

Misinformation about COVID-19 is a major threat to public health. Using five national samples from the UK (n = 1050 and n = 1150), Ireland (n = 700), the USA (n = 700), Spain (n = 700) and Mexico (n = 700), we examine predictors of belief in the most common statements about the virus that contain misinformation. We also investigate the prevalence of belief in COVID-19 misinformation across different countries and the role of belief in such misinformation in predicting relevant health behaviours. We find that while public belief in misinformation about COVID-19 is not particularly common, a substantial proportion views this type of misinformation as highly reliable in each country surveyed. In addition, a small group of participants find common factual information about the virus highly unreliable. We also find that increased susceptibility to misinformation negatively affects people's self-reported compliance with public health guidance about COVID-19, as well as people's willingness to get vaccinated against the virus and to recommend the vaccine to vulnerable friends and family. Across all countries surveyed, we find that higher trust in scientists and having higher numeracy skills were associated with lower susceptibility to coronavirus-related misinformation. Taken together, these results demonstrate a clear link between susceptibility to misinformation and both vaccine hesitancy and a reduced likelihood to comply with health guidance measures, and suggest that interventions which aim to improve critical thinking and trust in science may be a promising avenue for future research.

The unfolding COVID-19 pandemic: A probability-based, nationally representative study of mental health in the United States

The COVID-19 (coronavirus disease 2019) pandemic is a collective stressor unfolding over time; yet, rigorous empirical studies addressing its mental health consequences among large probability-based national samples are rare. Between 18 March and 18 April 2020, as illness and death escalated in the United States, we assessed acute stress, depressive symptoms, and direct, community, and media-based exposures to COVID-19 in three consecutive representative samples from the U.S. probability-based nationally representative NORC AmeriSpeak panel across three 10-day periods (total N = 6514). Acute stress and depressive symptoms increased significantly over time as COVID-19 deaths increased across the United States. Preexisting mental and physical health diagnoses, daily COVID-19-related media exposure, conflicting COVID-19 information in media, and secondary stressors were all associated with acute stress and depressive symptoms. Results have implications for targeting public health interventions and risk communication efforts to promote community resilience as the pandemic waxes and wanes over time.

The Adoption of Preventive Behaviors during the COVID-19 Pandemic in China and Israel

The COVID-19 pandemic represents a massive global health crisis. The rapid transmission rate of the virus, as well as the lack of effective medications and vaccines, has posed serious challenges to controlling the spread of the disease. Dealing with this public health crisis has required major changes in people’s behavior, including the adoption of social distancing measures such as avoiding meeting with family members and friends, crowded places, and public transportation. The purpose of this study is to investigate the factors associated with the adoption of these behaviors in China and Israel. We relied on the 3Cs model that has been used to predict the adoption of a specific preventive behavior (vaccinations) with the goal of testing its applicability to other preventive behaviors such as in response to the COVID-19 pandemic. The model indicates that confidence in social institutions, complacency (fear of and assessments about the risk of becoming ill) and constraints (levels of self-efficacy and confidence in being able to engage in the behaviors) are predictors of adopting preventive behaviors. Data were collected in China and Israel through an online survey of the population (n = 1406). We used latent variables and structural equation modeling to test the hypotheses derived from the 3Cs model. The findings indicate that there are some differences in the types of preventive behaviors adopted in the two countries. In Israel, higher levels of confidence predicted the adoption of avoidant behaviors and more constraints predicted engaging in fewer avoidant behaviors. In China, more constraints also contributed to the adoption of fewer avoidant behaviors, but people’s level of confidence fully mediated this result. The multi-group analysis indicated that the conceptualized model fits the Chinese and Israeli data reasonably well. The findings suggest that the 3Cs model can be generalized from getting vaccinated to adopting avoidant behaviors and that the model can be used across cultures and countries.

Optimism Bias during the Covid-19 Pandemic: Empirical Evidence from Romania and Italy

Given the importance of perceived susceptibility to a disease in adopting preventive behaviors, and the negative impact of optimism bias on prevention, this paper aimed to explore to what extent comparative optimism bias (understood as the tendency to assess a lower probability for oneself to experience negative health events compared to others) is present in the specific context of the Covid-19 pandemic, in two countries with different profiles in terms of the spread of the disease: Italy and Romania. After identifying optimism bias in both countries, we tested whether it depends on respondents’ characteristics like gender, age, education, health status and whether or not they have the opportunity to work from home. We surveyed 1126 Romanians and 742 Italians, and found that optimism bias depends on self-reported health status, and that optimism bias increases with age. Inconclusive evidences were found regarding gender and education level, as well as the option to work from home.

Lay perspectives on social distancing and other official recommendations and regulations in the time of COVID-19: a qualitative study of social media posts

BACKGROUND

COVID-19 caused by a new form of coronavirus (SARS-CoV-2) first appeared in China end of 2019 and quickly spread to all counties of the world. To slow down the spread of the virus and to limit the pressure on the health care systems, different regulations and recommendations have been implemented by authorities, comprising amongst others the closure of all entertainment venues and social distancing. These measures have received mixed reactions, particularly from young individuals, with many not following available advice. Drawing on the information in social media discussion forums, the present study explores the reasons why people ignore the orders and recommendations of the authorities and why the authorities are unable to produce a shared sense of inclusion concerning protective measures against the COVID-19 outbreak.

METHODS

Three open-access social media forums (Reddit, Twitter, and YouTube comments) were systematically searched with respect to COVID-19-related beliefs, attitudes, and behaviours of individuals. The data was retrieved in the first 3 weeks of March 2020. Qualitative document analysis and qualitative content analysis were used as the methodical approach. The data was reviewed by all authors and jointly interpreted to minimise inconsistencies.

RESULTS

The study reveals that reasons such as information pollution on social media, the persistence of uncertainty about the rapidly spreading virus, the impact of the social environment on the individual, and fear of unemployment associated with inequality in the distribution of income lead people to ignore the orders and recommendations of the authorities. The findings suggest that government representatives and politicians could not produce a shared sense of inclusion concerning protective measures against the COVID-19 outbreak, due to not building trust among the public and taking concrete economic steps to satisfy them.

CONCLUSION

In uncertain crises, transparency in the presentation of information and government policies emerge as influential determinants in creating social susceptibility and solidarity. The differences between social classes constitute one of the important factors that affect the decision-making mechanisms of individuals in determining the necessary steps to be undertaken in times of crisis.

How Risk Perceptions, Not Evidence, Have Driven Harmful Policies on COVID-19

COVID-19 hits all of the cognitive triggers for how the lay public misjudges risk. Robust findings from the field of risk perception have identified unique characteristics of a risk that allow for greater attribution of frequency and probability than is likely to be aligned with the base-rate statistics of the risk. COVID-19 embodies these features. It is unfamiliar, invisible, dreaded, potentially endemic, involuntary, disproportionately impacts vulnerable populations such as the elderly and has the potential for widespread catastrophe. When risks with such characteristics emerge, it is imperative for there to be trust between those in governance and communication and the lay public in order to quell public fears. This is not the environment in which COVID-19 has emerged, potentially resulting in even greater perceptions of risk.

The novel coronavirus (COVID-2019) outbreak: Amplification of public health consequences by media exposure

The 2019 novel coronavirus (COVID-2019) has led to a serious outbreak of often severe respiratory disease, which originated in China and has quickly become a global pandemic, with far-reaching consequences that are unprecedented in the modern era. As public health officials seek to contain the virus and mitigate the deleterious effects on worldwide population health, a related threat has emerged: global media exposure to the crisis. We review research suggesting that repeated media exposure to community crisis can lead to increased anxiety, heightened stress responses that can lead to downstream effects on health, and misplaced health-protective and help-seeking behaviors that can overburden health care facilities and tax available resources. We draw from work on previous public health crises (i.e., Ebola and H1N1 outbreaks) and other collective trauma (e.g., terrorist attacks) where media coverage of events had unintended consequences for those at relatively low risk for direct exposure, leading to potentially severe public health repercussions. We conclude with recommendations for individuals, researchers, and public health officials with respect to receiving and providing effective communications during a public health crisis. (PsycInfo Database Record (c) 2020 APA, all rights reserved).