Developing and Maintaining Public Trust During and Post-COVID-19: Can We Apply a Model Developed for Responding to Food Scares?

Stakeholders' perspectives on barriers to and facilitators of school-based HPV vaccination in the context of COVID-19 pandemic-related disruption: a qualitative mixed methods study

Despite successfully implementing the Human Papilloma Virus Vaccine (HPVV) program, Saskatchewan (SK) struggled to improve HPVV uptake rates. This suboptimal uptake of HPVV with a status quo of HPV-linked cervical cancer incidence rate is mainly because HPVV's impact on cancer prevention has not been realized adequately by vaccine providers and receivers. Further exploration of determinants of HPVV uptake is required to uncover high-resolution quality improvement targets for investment and situate contextually appropriate policies to improve its uptake. The study undertook a qualitative inquiry into understanding stakeholders' perspectives on HPVV experience through school-based programmes. It collected data through semi-structured initial interviews (N = 16) and follow-up interviews (N = 10) from across Saskatchewan's four Integrated Service Areas. Document analysis was conducted on all publicly available documents that included information on HPVV from January 2015 to July 2023. Thematic analysis of the data identified that inadequate information, awareness and education about HPV infection and HPVV among several groups, especially, parents, youth and school staff, was the main barrier to optimal HPVV uptake. Vaccine-related logistics, including the technical and text-heavy vaccine information sheet, understaffing, and time constraints, were other important factors that impeded HPVV uptake. A person-centred approach could educate parents in multiple dimensions.

Strategically communicating inclusion efforts at hospitals: Trust-signalling for community engagement

Trust is a challenging and complex concept and takes on particular significance in the context of community engagement and communication in healthcare. For the purpose of making health services more inclusive and of tackling discrimination where it occurs, there is a need to articulate a vision for inclusion that communities of historically disadvantaged or stigmatised patients can trust. This article considers examples of diversity and inclusion 'signals' on the public websites of two large public hospitals in Melbourne, Australia. We suggest that there is value in public communications reaffirming respect for diversity and a commitment to inclusion in health services. We also make the case for interdisciplinary research into how trust-signalling strategies, that is, rhetorical strategies employed to reassure or convince, are developed by and for health services for the purposes of community engagement, and the specific effects that they may engender. Websites' framing of messages that affirm institutional commitments to fostering an inclusive environment and addressing barriers can serve as a means of explicitly encouraging patients and healthcare workers from marginalised communities to overcome potential obstacles to fuller healthcare engagement and workforce participation respectively.

COVID-19 related messaging, beliefs, information sources, and mitigation behaviors in Virginia: a cross-sectional survey in the summer of 2020

Background

Conflicting messages and misleading information related to the coronavirus (COVID-19) pandemic (SARS-CoV-2) have hindered mitigation efforts. It is important that trust in evidence-based public health information be maintained to effectively continue pandemic mitigation strategies. Officials, researchers, and the public can benefit from exploring how people receive information they believe and trust, and how their beliefs influence their behaviors.

Methods

To gain insight and inform effective evidence-based public health messaging, we distributed an anonymous online cross-sectional survey from May to July, 2020 to Virginia residents, 18 years of age or older. Participants were surveyed about their perceptions of COVID-19, risk mitigation behaviors, messages and events they felt influenced their beliefs and behaviors, and where they obtained information that they trust. The survey also collected socio-demographic information, including gender, age, race, ethnicity, level of education, income, employment status, occupation, changes in employment due to the pandemic, political affiliation, sexual orientation, and zip code. Analyses included specific focus on the most effective behavioral measures: wearing a face mask and distancing in public.

Results

Among 3,488 respondents, systematic differences were observed in information sources that people trust, events that impacted beliefs and behaviors, and how behaviors changed by socio-demographics, political identity, and geography within Virginia. Characteristics significantly associated (p < 0.025) with not wearing a mask in public included identifying as non-Hispanic white, male, Republican political identity, younger age, lower income, not trusting national science and health organizations, believing one or more non-evidence-based messages, and residing in Southwest Virginia in logistic regression. Similar, lesser in magnitude correlations, were observed for distancing in public.

Conclusions

This study describes how information sources considered trustworthy vary across different populations and identities, and how these differentially correspond to beliefs and behaviors. This study can assist decision makers and the public to improve and effectively target public health messaging related to the ongoing COVID-19 pandemic and future public health challenges in Virginia and similar jurisdictions.

Overview of the Health Communication Curriculum in Canadian Master of Public Health Programs

CONTEXT

Competency-based public health education ensures practitioners are well equipped to positively influence the health of the public. The Public Health Agency of Canada's Core Competencies for Public Health has named communication as an essential competency area for practitioners. However, little is known about how Master of Public Health (MPH) programs in Canada support trainees in developing the recommended core competencies in communication.

OBJECTIVE

Our research aims to provide an overview of the extent to which communication is embedded in the curriculum of MPH programs in Canada.

DESIGN

We conducted an online scan of Canadian MPH course titles and descriptions to determine how many MPH programs offer communication-focused courses (ie, health communication), knowledge mobilization courses (eg, knowledge translation), and other courses that may support communication skills. Two researchers coded the data; discrepancies were resolved via discussion.

RESULTS

Of the 19 MPH programs in Canada, less than half (n = 9) offer courses specifically focused on communication (ie, health communication); these courses are mandatory in only 4 programs. Seven programs offer knowledge mobilization courses; none are mandatory. Sixteen MPH programs offer a total of 63 other public health courses that are not focused on communication but contain communication terms (eg, marketing, literacy) in their course descriptions. No Canadian MPH program has a communication-focused stream or option.

CONCLUSION

Canadian-trained MPH graduates may not be receiving sufficient communication training to equip them for effective and precise public health practice. This is particularly concerning, given that current events have underlined the importance of health, risk, and crisis communication.

Challenges for contactless online food delivery services during the COVID-19 pandemic in Taiwan: Moderating effects of perceived government response

The COVID-19 pandemic has affected numerous industries worldwide, altered consumer behavior, and increased demand for contactless online food delivery (OFD) services. COVID-19 information from the government may influence the public's information-seeking behavior regarding OFD services. Thus, exploring the relationship between contactless OFD and consumer perceptions of the government response during the pandemic is essential. This paper probed the effects exerted by three behavioral beliefs, namely health consciousness, self-efficacy, and perceived benefits, on consumers' intention and attitude toward contactless online food delivery (OFD) services. This study explored the moderating impact exerted by perceived government response to the COVID-19 pandemic on the relationship between attitude and intention toward OFD services. The study results indicated that self-efficacy and perceived benefits positively influenced the respondents' attitude toward contactless OFD services. Health consciousness negatively influenced their attitude toward these services. The respondents' attitude toward contactless OFD services to be positively related to their behavioral intention toward such services. Perceived government response to COVID-19 moderated the relationship between respondents' attitude and behavioral intention toward contactless OFD services. Based on the study findings, some suggestions are provided for governments, other relevant agencies, and OFD service providers herein.

'A war of a different kind': local municipalities' experiences in managing the COVID-19 pandemic in Israel-a qualitative study

OBJECTIVES

In Israel, in 2020, 57/257 local municipalities were part of the Healthy Cities Network (HCN). HCN municipalities have a strong political commitment to health promotion and reducing health inequalities. This research aimed to (1) explore local municipalities' management of the pandemic and (2) assess whether belonging to the HCN impacted this management.

DESIGN, SETTING AND PARTICIPANTS

Fourteen municipalities were chosen-seven HCN municipalities, matched to seven non-HCN municipalities. In each municipality, semistructured telephone interviews were conducted with three to four officials. Interviews were recorded, transcribed and analysed using inductive thematic coding, both in general and specifically to compare HCN and non-HCN municipalities.

RESULTS

Forty-two interviews were conducted, with five main themes: (1) relationship with the government; with the transference of information to the local municipalities found to be challenging and a strong need for more independence at the local level; (2) contact with residents which was divided into several actions, such as mapping the city population, supporting vulnerable populations and managing volunteers; (3) relationships within the municipality which included a sense of collaboration and community but also a feeling of wear out; (4) difference between the first lockdown compared with following lockdowns; within these themes, no significant differences were found between HCN municipalities and non-HCN municipalities and (5) the role of the Healthy City (HC) coordinator which was critical in several municipalities. They served as brokers, had a pre-existing intersectoral network and held a broader vision of health.

CONCLUSIONS

Local municipalities in Israel played an important role in the pandemic response. Municipalities requested a central information source and more independence at the local level. Challenges and responses were similar across municipalities and residents, regardless of their HCN status. However, in some municipalities, the role of the HC coordinator was crucial for the pandemic response due to pre-existing interprofessional and intersectoral networks.

Trust In US Federal, State, And Local Public Health Agencies During COVID-19: Responses And Policy Implications

Public health agencies' ability to protect health in the wake of COVID-19 largely depends on public trust. In February 2022 we conducted a first-of-its-kind nationally representative survey of 4,208 US adults to learn the public's reported reasons for trust in federal, state, and local public health agencies. Among respondents who expressed a "great deal" of trust, that trust was not related primarily to agencies' ability to control the spread of COVID-19 but, rather, to beliefs that those agencies made clear, science-based recommendations and provided protective resources. Scientific expertise was a more commonly reported reason for "a great deal" of trust at the federal level, whereas perceptions of hard work, compassionate policy, and direct services were emphasized more at the state and local levels. Although trust in public health agencies was not especially high, few respondents indicated that they had no trust. Lower trust was related primarily to respondents' beliefs that health recommendations were politically influenced and inconsistent. The least trusting respondents also endorsed concerns about private-sector influence and excessive restrictions and had low trust in government overall. Our findings suggest the need to support a robust federal, state, and local public health communications infrastructure; ensure agencies' authority to make science-based recommendations; and develop strategies for engaging different segments of the public.

Taking a Shot: The Impact of Information Frames and Channels on Vaccination Willingness in a Pandemic

The reluctance of people to receive safe and recommended available vaccines is a well-documented public health challenge. As information and communication technologies evolve, this challenge gets more complex and even harder to manage during complex public health situations. In this experimental study, we examine the relationship between vaccine information frames (with scientific information vs. without scientific information) and channels (through government vs. religious organizations) and vaccination willingness in the U.S. in the context of a pandemic. Additionally, we evaluate the interaction between vaccine skepticism, vaccine information frames, and vaccine information channels on vaccination willingness. This experimental study uses data from Amazon Mechanical Turk (MTURK) to evaluate the relationships between vaccine skepticism, vaccine information frames, and channels on vaccination willingness. We find that contrary to our hypothesis, a vaccine advisory framed with scientific information decreases people's vaccination willingness compared to one framed without scientific information. Additionally, the impact of framing on vaccination willingness is conditioned on participants' skepticism-participants who hold skepticism toward the vaccine but received information framed with scientific information score significantly higher in vaccination willingness compared to participants who do not hold skepticism toward a vaccine. The results suggest that the factors impacting vaccination willingness are complex and nuanced. Thus, policymakers should be more strategic with the delivery of vaccination information, especially during complex health crises.

Exploring indirect impacts of COVID-19 on local health systems from the perspectives of health workers and higher education stakeholders in the Philippines using a phenomenological approach

BACKGROUND

Our study aimed to explore the experiences of stakeholders from local government units, health facilities and higher education institutions on the delivery of non-COVID-19 health services after the initial wave of the pandemic.

METHODS

Twenty-nine public health workers, thirteen university staff, and four hospital administrators in the Philippines participated. Using a descriptive phenomenological approach, we analysed transcripts from six focus group discussions conducted online between March and June 2021.

FINDINGS

The COVID-19 pandemic made the routine health programs inaccessible due to hesitancy among patients to visit health facilities, a shift in public health priorities, and lack of students to augment the existing workforce.Public health workers reported stress and mental health exhaustion. Apart from fear of infection during service provision, public health workers and university staff experienced work overload, pressure to learn new technology, and webinar fatigue. Mental health problems have surfaced as health workers and young people have become more affected while support services remain insufficient.Public health workers have reported actions to maintain service delivery in the new normal such as use of telehealth and social media. However, issues on workforce wellbeing and digital equity posed adaptation challenges. Participants suggested partnership with higher education institutions as pivotal to position local health systems towards recovery.

INTERPRETATION

The rapid change in the service landscape highlights the importance of sustainable partnerships, effective workforce management, equitable digital innovations, and promoting mental wellbeing to preserve community, school, and occupational health and rebuild resilient local health systems in low-resourced areas.

FUNDING

This research is proudly supported by the Australia-ASEAN Council, Australian Government Department of Foreign Affairs and Trade.

Characterising trusted spokespeople in noncommunicable disease prevention: A systematic scoping review

Noncommunicable diseases (NCD) are an increasing global threat. Utilising public policy to address NCDs can reduce incidence and prevalence. However, NCD-relevant public policy action is minimal in many countries as changing public policy is difficult and multifactorial. Two factors that may influence this process is the message people receive and the messenger delivering it. To date, much health communication research has focused on message content, with limited research on messengers that are trusted by policymakers and the public to communicate NCD matters. We aimed to review the literature to characterise who the public and policymakers consider to be trustworthy and/or credible for NCD messaging, and why this might be the case. Arksey and O'Malley's scoping review methodology guided the review. A systematic search of three databases up to June 2021 combined with hand searching of review reference lists was undertaken. Nineteen articles were included. Data extraction focused on study design, issue being influenced, spokesperson studied, and measures of trust. Results showed health professionals were the most-frequently trusted sources of information. Other spokespeople, such as government sources or religious leaders, were only trustworthy in some contexts, and even distrusted in others. Reasons why spokespeople were trusted included technical expertise, strategic engagement with stakeholders, and reputation. However, we also found the nature of trust and credibility of spokespeople is dependent on the studied population and context. Overall, characteristics of influential messengers were nonspecific. Thus, trusted messengers and their characteristics in NCD-messaging must be better understood to develop and maintain the trust of the public and policymakers.

Building local decision-making competencies during COVID-19: Accelerating the transition from learning healthcare systems to learning health communities

Introduction

The persisting and evolving COVID-19 pandemic has made apparent that no singular policy of mitigation at a regional, national or global level has achieved satisfactory and universally acceptable results. In the United States, carefully planned and executed pandemic policies have been neither effective nor popular and COVID-19 risk management decisions have been relegated to individual citizens and communities. In this paper, we argue that a more effective approach is to equip and strengthen community coalitions to become local learning health communities (LLHCs) that use data over time to make adaptive decisions that can optimize the equity and well-being in their communities.

Methods

We used data from the North Carolina (NC) county and zip code levels from May to August 2020 to demonstrate how a LLHC could use statistical process control (SPC) charts and simple statistical analysis to make local decisions about how to respond to COVID-19.

Results

We found many patterns of COVID-19 progression at the local (county and zip code) levels during the same time period within the state that were completely different from the aggregate NC state level data used for policy making.

Conclusions

Systematic approaches to learning from local data to support effective decisions have promise well beyond the current pandemic. These tools can help address other complex public health issues, and advance outcomes and equity. Building this capacity requires investment in data infrastructure and the strengthening of data competencies in community coalitions to better interpret data with limited need for advanced statistical expertise. Additional incentives that build trust, support data transparency, encourage truth-telling and promote meaningful teamwork are also critical. These must be carefully designed, contextually appropriate and multifaceted to motivate citizens to create and sustain an effective learning system that works for their communities.

A Lesson from the Green Pass Experience in Italy: A Narrative Review

The COVID-19 outbreak has raised several global challenges related to disease management while highlighting the need to embrace a multidimensional approach in dealing with events such as. Due to the singular features of SARS-CoV-2, an appropriate medical response was required to develop new vaccines able to tackle it effectively. Mass vaccination plans were thus promptly launched around the world. However, vaccine uptake has been coupled with growing concerns that have affected people’s willingness to get vaccinated. To promote compliance with vaccination campaigns, many governments introduced the use of vaccination certificates and immunization passports. Studies have discussed some benefits and cons coupled with the rollout of vaccine passports or certificates. This paper takes up and extends this discussion by showing the results of a mini- narrative review we undertook with the aim of critically summarizing the existing scholarly research on the Green Pass in Italy. In analyzing the 12 included records, we explored the scientific viability of this measure, as well as the concerns and criticisms it has raised and the recommendations that have been proposed to address them, as a starting point to consider how the lesson learned in the Italian context can contribute to informing future reflections and strategies in view ofanother pandemic event.

Social cohesion and loneliness are associated with the antibody response to COVID-19 vaccination

BACKGROUND

Recent research has suggested that psychosocial factors influence the antibody response to vaccine, including SARS-CoV-2 (COVID-19) vaccines. Here we investigated whether social cohesion and loneliness were predictive of antibody response to a single dose of a COVID-19 vaccine. We also tested if the association between social cohesion and antibody response was mediated by feelings of loneliness.

METHODS

Participants (N = 676) COVID-19 antibody data were extracted from March 2021 wave of the Understanding Society COVID-19 study from the UK. Relevant socio-demographics, health and lifestyle, loneliness, social cohesion indices were also used in a series of hierarchical linear regression to test our main hypotheses.

RESULTS

After controlling for covariates (e.g., age and chronic health conditions), lower social cohesion was associated with a lower antibody response. Further, the association between social cohesion and poorer antibody responses was mediated by loneliness; those reporting lower social cohesion also reported higher loneliness, which in turn was associated with lower antibody response.

CONCLUSION

This study confirms that feelings of 'being in it together' relate to the strength of the antibody response to COVID-19 vaccination, emphasising the importance of the social cohesion agenda during the pandemic.

Canadian COVID-19 Crisis Communication on Twitter: Mixed Methods Research Examining Tweets from Government, Politicians, and Public Health for Crisis Communication Guiding Principles and Tweet Engagement

To foster trust on social media during a crisis, messages should implement key guiding principles, including call to action, clarity, conversational tone, compassion and empathy, correction of misinformation, and transparency. This study describes how crisis actors used guiding principles in COVID-19 tweets, and how the use of these guiding principles relates to tweet engagement. Original, English language tweets from 10 federal level government, politician, and public health Twitter accounts were collected between 11 March 2020 and 25 January 2021 (n = 6053). A 60% random sample was taken (n = 3633), and the tweets were analyzed for guiding principles. A tweet engagement score was calculated for each tweet and logistic regression analyses were conducted to model the relationship between guiding principles and tweet engagement. Overall, the use of guiding principles was low and inconsistent. Tweets that were written with compassion and empathy, or conversational tone were associated with greater odds of having higher tweet engagement. Across all guiding principles, tweets from politicians and public health were associated with greater odds of having higher tweet engagement. Using a combination of guiding principles was associated with greater odds of having higher tweet engagement. Crisis actors should consistently use relevant guiding principles in crisis communication messages to improve message engagement.

A call for citizen science in pandemic preparedness and response: beyond data collection

The COVID-19 pandemic has underlined the need to partner with the community in pandemic preparedness and response in order to enable trust-building among stakeholders, which is key in pandemic management. Citizen science, defined here as a practice of public participation and collaboration in all aspects of scientific research to increase knowledge and build trust with governments and researchers, is a crucial approach to promoting community engagement. By harnessing the potential of digitally enabled citizen science, one could translate data into accessible, comprehensible and actionable outputs at the population level. The application of citizen science in health has grown over the years, but most of these approaches remain at the level of participatory data collection. This narrative review examines citizen science approaches in participatory data generation, modelling and visualisation, and calls for truly participatory and co-creation approaches across all domains of pandemic preparedness and response. Further research is needed to identify approaches that optimally generate short-term and long-term value for communities participating in population health. Feasible, sustainable and contextualised citizen science approaches that meaningfully engage affected communities for the long-term will need to be inclusive of all populations and their cultures, comprehensive of all domains, digitally enabled and viewed as a key component to allow trust-building among the stakeholders. The impact of COVID-19 on people's lives has created an opportune time to advance people's agency in science, particularly in pandemic preparedness and response.

Do government activities increase public compliance in the Covid-19 pandemic? Evidence from Vietnam

Purpose

During the COVID-19 pandemic, it has raised an important question of whether government efforts (GEFs), especially communication work, could prevent the outbreak of this pandemic by enhancing public trust and public compliance with the government. This research answers this question by focusing on the case of Vietnam, a low-resource country that gained some achievements during the first pandemic year 2020. In particular, this study aims to investigate the relationship between GEF, public trust and public compliance during the country’s first nationwide social distancing.

Design/methodology/approach

The structural equation modelling is used to analyse data collected from 467 respondents in Vietnam during the nationwide social distancing in 2020.

Findings

Perceived GEF is positively associated with public compliance with the government directly and indirectly through the mediating role of public trust in government (PTG). The empirical results also reveal the effectiveness of government communication work, one among the government’s great efforts, during the COVID-19 pandemic, in terms of intensity and diversity in communication and information channels.

Practical implications

During a pandemic, the governments must enhance public compliance with public health measures to implement the anti-epidemic missions effectively. Therefore, it is important to raise public perception of GEF and PTG. The study’s findings highlight that governments in developing countries should implement relevant responses and policies for the ongoing COVID-19 pandemic and future public health crises, especially in the context that effective vaccines are unavailable or insufficient.

Originality/value

To the best of the authors’ knowledge, this research is among the first attempts that examine the role of GEF, especially public health communication work, in raising public compliance directly and indirectly through the mediating role of public trust. The study carries some important messages for containing a public health crisis like the COVID-19 pandemic.

Travel decision determinants during and after COVID-19: The role of tourist trust, travel constraints, and attitudinal factors

The COVID-19 pandemic has forced tourism practitioners to create efficient strategies to attract travelers. Using three theoretical frameworks, such as tourist trust (political, destination, and interactional trust), travel constraint (intrapersonal, interpersonal, and "social distancing" structural constraint), and extended theory of planned behavior (travel attitude, perceived behavioral control, subjective norm, perceived health risk, past travel experience), we develop a comprehensive framework to explain the impact of travel promoting, restricting, and attitudinal factors on travel decision during and after the pandemic. Data was obtained through an extensive survey conducted on 1451 Korean travelers and was analyzed using probabilistic choice models and count models. The results show the specific factors that determine travel decisions during the pandemic (whether to travel and frequency) and travel intention after the pandemic. This study provides important theoretical and practical insights into how to develop successful COVID-19 recovery strategies in the tourism industry.

Peers for the fearless: Social norms facilitate preventive behaviour when individuals perceive low COVID-19 health risks

A strategy frequently adopted to contain the COVID-19 pandemic involves three non-pharmaceutical interventions that depend on high levels of compliance in society: maintaining physical distance from others, minimizing social contacts, and wearing a face mask. These measures require substantial changes in established practices of social interaction, raising the question of which factors motivate individuals to comply with these preventive behaviours. Using Austrian panel survey data from April 2020 to April 2021, we show that perceived health risks, social norms, and trust in political institutions stimulate people to engage in preventive behaviour. A moderation analysis shows that the effectiveness of social norms in facilitating preventive behaviour increases when people's perceptions of health risks decrease. No such moderation effect is observed for trust in political institutions. These results suggest that strong social norms play a crucial role in achieving high rates of preventive behaviour, especially when perceived levels of health risks are low.

Framing the nanny (state): an analysis of public submissions to a parliamentary inquiry on personal choice and community safety

OBJECTIVE

To examine public submissions to a parliamentary inquiry on personal choice and community safety, exploring framing used to support or oppose current public health regulatory approaches.

METHODS

Descriptive content analysis summarised the characteristics of electronic submissions. Framing analysis examined submissions according to the devices: problem and causes; principles and values; recommendations; data and evidence; and salience.

RESULTS

We categorised one hundred and five (n=105) submissions by source as Individual, Industry, Public Health and Other. Individuals made more than half the submissions. Overarching frames were choice and rights (Individuals); progress and freedom (Industry); protection and responsibility (Public Health). Most submissions opposed current regulations. Cycling, including mandatory helmet legislation, was most cited, with three-quarters of submissions opposing current legislation.

CONCLUSIONS

Framing analysis provided insights into policy actor agendas concerning government regulation. We found a high degree of resistance to public health regulation that curtails individual autonomy across various health issues. Investigating the influence of different frames on community perception of public health regulation is warranted. Implications for public health: Action is required to counteract 'nanny state' framing by industry and to problematise community understanding of the 'nanny state' in the context of balancing the public's liberties and the public's health.

COVID-19 and beyond: Use of digital technology for pandemic response in Africa

The use of technology has been ubiquitous in efforts to combat the ongoing COVID-19 pandemic. In this perspective, we review technologies and new approaches developed at the start of the pandemic; efforts earmarked by a flexible approach to problem solving, local tech entrepreneurship, and swift adoption of technology. We performed a systematic review of the use of technology during the initial wave of the COVID-19 pandemic in most African countries. We identified relevant articles by searching for mentions of technology, COVID-19, and specific country names. Articles were included if they specifically mentioned the use of technology or novel innovations in the response to the COVID-19 pandemic in an African country. The article search was conducted in August and included articles published between January and August 2020. We retrieved articles from journals, trusted news, government, and organization websites on Google, Google Scholar and PubMed. A total of 80 articles were retained and categorized under Disease Prevention (19 articles), Disease Surveillance xxx Antipoaching Tech Tracks COVID-19 Flare-Ups in South Africa - Scientific American. (2020, May 12), and Clinical Supplies and Management xxx Ethiopia's digital health response to COVID-19 - JSI. (2020, May 14). African nations used technology and innovative techniques to manage patients, monitor cases and disseminate information to counter the spread of COVID-19. The nature and outcomes of these efforts sometimes differed in Africa compared to other regions of the world due to its unique challenges and opportunities.

Citizens' trust in government as a function of good governance and government agency's provision of quality information on social media during COVID-19

Evidence from literature reveals that good governance practices influence citizens' attitudes and behaviours towards the government. Therefore, grounded on the good governance theory, the current study aimed to empirically examine how good governance practices promote public trust with the underlying mechanism of perceived government response on COVID-19 (PGRC) and moderating role of government agency's provision of quality information on social media (GQS). The data was collected from 491 followers of the Facebook account, Instagram, and Twitter pages of a government news agency, i.e., Associated Press of Pakistan and were analyzed using measurement and structural model by employing SmartPls 3.3.0. The results revealed a direct and indirect association of good governance practices with the public's trust in government via PGRC as mediator. Likewise, results showed that GQS interacts with PGRC and augments public trust in government. This study tried to contribute to the body of knowledge while addressing the gap related to the dearth of literature regarding government use of ICT during the COVID-19 pandemic to harvest benefits from social media while communicating with citizens on a larger scale. Moreover, the current study offers valuable practical and strategical recommendations to agencies and policymakers.

A Review and Analysis of the Literature on Public Health Emergency Communication Practices

A systematic review using structured and transparent methods was carried out to collect and review the qualitative literature investigating trust in crisis communication during emerging infectious diseases. Qualitative synthesis was conducted using a descriptive thematic analysis approach. The GRADE-CERQual assessment was used to determine the confidence in each thematic finding to support decisions when implementing review findings. Overall, 13 studies were included in the review, resulting in 10 thematic categories that describe characteristics associated with crisis communication information and sources of crisis communication that can enhance or maintain public trust. The results of this review suggest the public judges the trustworthiness of crisis communication based on the information characteristics, including consistency, repetition, and timeliness, and especially transparency and uncertainty. Public health is a trusted source of crisis communication when the presenting spokesperson is a health official, the information is not perceived as politicized, and is timely. Community leaders, such as family doctors, are also trusted sources of crisis communication, whereas media and government officials face distrust because of perceived sensationalized information, and defensiveness and unreliable information respectively. Qualitative data in this area is limited, especially involving the public and priority populations, and should be the focus of future research.

Examining Social Media Crisis Communication during Early COVID-19 from Public Health and News Media for Quality, Content, and Corresponding Public Sentiment

Rising COVID-19 cases in Canada in early 2021, coupled with pervasive mis- and disinformation, demonstrate the critical relationship between effective crisis communication, trust, and risk protective measure adherence by the public. Trust in crisis communication is affected by the communication's characteristics including transparency, timeliness, empathy, and clarity, as well as the source and communication channels used. Crisis communication occurs in a rhetorical arena where various actors, including public health, news media, and the public, are co-producing and responding to messages. Rhetorical arenas must be monitored to assess the acceptance of messaging. The quality and content of Canadian public health and news media crisis communication on Facebook were evaluated to understand the use of key guiding principles of effective crisis communication, the focus of the communication, and subsequent public emotional response to included posts. Four hundred and thirty-eight posts and 26,774 anonymized comments were collected and analyzed. Overall, the guiding principles for effective crisis communication were inconsistently applied and combined. A limited combination of guiding principles, especially those that demonstrate trustworthiness, was likely driving the negative sentiment uncovered in the comments. Public health and news media should use the guiding principles consistently to increase positive sentiment and build trust among followers.

How Are the Links between Alcohol Consumption and Breast Cancer Portrayed in Australian Newspapers?: A Paired Thematic and Framing Media Analysis

A dose-dependent relationship between alcohol consumption and increased breast cancer risk is well established, even at low levels of consumption. Australian women in midlife (45–64 years) are at highest lifetime risk for developing breast cancer but demonstrate low awareness of this link. We explore women’s exposure to messages about alcohol and breast cancer in Australian print media in the period 2002–2018. Methods: Paired thematic and framing analyses were undertaken of Australian print media from three time-defined subsamples: 2002–2004, 2009–2011, and 2016–2018. Results: Five key themes arose from the thematic framing analysis: Ascribing Blame, Individual Responsibility, Cultural Entrenchment, False Equilibrium, and Recognition of Population Impact. The framing analysis showed that the alcohol–breast cancer link was predominantly framed as a behavioural concern, neglecting medical and societal frames. Discussion: We explore the representations of the alcohol and breast cancer risk relationship. We found their portrayal to be conflicting and unbalanced at times and tended to emphasise individual choice and responsibility in modifying health behaviours. We argue that key stakeholders including government, public health, and media should accept shared responsibility for increasing awareness of the alcohol–breast cancer link and invite media advocates to assist with brokering correct public health information.

An interaction effect of perceived government response on COVID-19 and government agency’s use of ICT in building trust among citizens of Pakistan

Purpose

Among the digital age players, one of the fastest-growing digital channels is social media. In the past few years, developing nations’ government entities and political parties started using social media platforms to broadcast important information regarding decisions made at the state level. Pakistan is among those countries. Therefore, this study aims to empirically investigate the impact of the government agency’s provision of quality information on social media in establishing trust among citizens of Pakistan in a government agency with an underlying mechanism of citizens’ perception about agency’s transparency and responsiveness along with moderating role of perceived government response on COVID-19.

Design/methodology/approach

Data was collected from 542 social media followers of the Associated Press of Pakistan (a government news agency) and was analysed using measurement and structural models by using SmartPLS 3.3.0.

Findings

Results revealed that the interactive effect of government response on COVID-19 and government agency’s provision of quality information on social media strengthens the association of government presence on social media with citizens’ perception of the agency’s transparency and responsiveness and their trust in the agency.

Practical implications

Furthermore, the current study will contribute to the body of knowledge regarding the government agency’s use of information and communication technology and the government’s resultant response on COVID-19.

Originality/value

An extensive study of the literature revealed a gap available regarding the mediatory role of the citizens’ perception about agency’s transparency and responsiveness in between the association of government agency’s provision of quality information on social media and citizens’ trust in the government agency. Also, to the best of the author’s knowledge, no study to date has investigated the moderating role of government response on COVID-19 in between the relationship of government agency’s provision of quality on social media and citizens’ trust in the government agency and their perception about agency’s transparency and responsiveness. Thus, the current study aimed to address these existing gaps in the literature.

Hesitation and Refusal Factors in Individuals' Decision-Making Processes Regarding a Coronavirus Disease 2019 Vaccination

Introduction: Considering the global prevalence of coronavirus disease 2019 (COVID-19), a vaccine is being developed to control the disease as a complementary solution to hygiene measures-and better, in social terms, than social distancing. Given that a vaccine will eventually be produced, information will be needed to support a potential campaign to promote vaccination. Objective: The aim of this study was to determine the variables affecting the likelihood of refusal and indecision toward a vaccine against COVID-19 and to determine the acceptance of the vaccine for different scenarios of effectiveness and side effects. Materials and Methods: A multinomial logistic regression method based on the Health Belief Model was used to estimate the current methodology, using data obtained by an online anonymous survey of 370 respondents in Chile. Results: The results indicate that 49% of respondents were willing to be vaccinated, with 28% undecided or 77% of individuals who would potentially be willing to be inoculated. The main variables that explained the probability of rejection or indecision were associated with the severity of COVID-19, such as, the side effects and effectiveness of the vaccine; perceived benefits, including immunity, decreased fear of contagion, and the protection of oneself and the environment; action signals, such as, responses from ones' family and the government, available information, and specialists' recommendations; and susceptibility, including the contagion rate per 1,000 inhabitants and relatives with COVID-19, among others. Our analysis of hypothetical vaccine scenarios revealed that individuals preferred less risky vaccines in terms of fewer side effects, rather than effectiveness. Additionally, the variables that explained the indecision toward or rejection of a potential COVID-19 vaccine could be used in designing public health policies. Conclusions: We discovered that it is necessary to formulate specific, differentiated vaccination-promotion strategies for the anti-vaccine and undecided groups based on the factors that explain the probability of individuals refusing or expressing hesitation toward vaccination.

Reciprocal Trust as an Ethical Response to the COVID-19 Pandemic

The COVID-19 pandemic has generated a range of responses from countries across the globe in managing and containing infections. Considerable research has highlighted the importance of trust in ethically and effectively managing infectious diseases in the population; however, considerations of reciprocal trust remain limited in debates on pandemic response. This paper aims to broaden the perspective of good ethical practices in managing an infectious disease outbreak by including the role of reciprocal trust. A synthesis of the approaches drawn from South Korea and Taiwan reveals reciprocal trust as an important ethical response to the COVID-19 pandemic. Reciprocal trust offers the opportunity to reconcile the difficulties arising from restrictive measures for protecting population health and individual rights.

Determinants of Overall Public Trust in Local Government: Meditation of Government Response to COVID-19 in Indonesian Context

Purpose

This study aims to empirically investigate the relationship of perceived transparency, perceived accountability and perceived responsiveness with overall public trust in local government. Moreover, it addressed the “why” and “how” questions about the existence of this relationship by examining the underlying mechanism of the government response to COVID-19.

Design/methodology/approach

Quantitative research design is applied in the current study. Data was collected from two cities situated in Indonesia via a cross-sectional survey at local administration levels. The final data set of 330 respondents was then analyzed using Smart partial least square (PLS)3 by testing through the measurement and structural model.

Findings

Results revealed positive associations among the study variables. Also, the mediatory role of the government response to COVID-19 was supported by the results.

Originality/value

This study aims to bring awareness and contribution in the body of knowledge about the importance of elements of good governance in building and sustaining public trust in local governments based on the fact that in countries such as Indonesia, there is a dearth of literature in this context. Further, it provides strategic and practical suggestions to the state regarding the advantages of using good governance practices in their communication with citizens in certain and uncertain situations, especially nowadays during the COVID-19 pandemic.

Does High Public Trust Amplify Compliance with Stringent COVID-19 Government Health Guidelines? A Multi-country Analysis Using Data from 102,627 Individuals

PURPOSE

To examine how public trust mediates the people's adherence to levels of stringent government health policies and to establish if these effects vary across the political regimes.

METHODS

This study utilizes data from two large-scale surveys: the global behaviors and perceptions at the onset of COVID-19 pandemic and the Oxford COVID-19 Government Response Tracker (OxCGRT). Linear regression models were used to estimate the effects of public trust and strictness of restriction measures on people's compliance level. The model accounted for individual and daily variations in country-level stringency of preventative measures. Differences in the dynamics between public trust, the stringent level of government health guidelines and policy compliance were also examined among countries based on political regimes.

RESULTS

We find strong evidence of the increase in compliance due to the imposition of stricter government restrictions. The examination of heterogeneous effects suggests that high public trust in government and the perception of its truthfulness double the impact of policy restrictions on public compliance. Among political regimes, higher levels of public trust significantly increase the predicted compliance as stringency level rises in authoritarian and democratic countries.

CONCLUSION

This study highlights the importance of public trust in government and its institutions during public health emergencies such as the COVID-19 pandemic. Our results are relevant and help understand why governments need to address the risks of non-compliance among low trusting individuals to achieve the success of the containment policies.

COVID-19 Amplifiers on Health Inequity Among the Older Populations

The coronavirus disease 2019 (COVID-19) is affecting the population disproportionately and is continuously widening the health gap among the population. Based on some recent studies on COVID-19 and the older population, the various cascades toward health inequity have been projected. This study highlights how the COVID-19 is met by health inequity triggers, such as global trade inequality, ageist social regulations, and the existing social inequity. While those triggers are applicable to all the populations, there seems to be specific amplifiers for health inequity among the older populations. In particular, six types of amplifiers have been identified: (1) expansion of riskscape, (2) reduction of social ties, (3) uncertainty of future, (4) losing trust in institutions, (5) coping with new knowledge, and (6) straining on public spending. While the fundamental mitigating responses to health inequity among the older population is tackling existing inequalities, this study may help to shed light on emerging vulnerabilities among the older population to alleviate far-reaching consequences of COVID-19 of the identified inequity amplifiers.

Hesitation and Refusal Factors in Individuals' Decision-Making Processes Regarding a Coronavirus Disease 2019 Vaccination

Introduction: Considering the global prevalence of coronavirus disease 2019 (COVID-19), a vaccine is being developed to control the disease as a complementary solution to hygiene measures-and better, in social terms, than social distancing. Given that a vaccine will eventually be produced, information will be needed to support a potential campaign to promote vaccination. Objective: The aim of this study was to determine the variables affecting the likelihood of refusal and indecision toward a vaccine against COVID-19 and to determine the acceptance of the vaccine for different scenarios of effectiveness and side effects. Materials and Methods: A multinomial logistic regression method based on the Health Belief Model was used to estimate the current methodology, using data obtained by an online anonymous survey of 370 respondents in Chile. Results: The results indicate that 49% of respondents were willing to be vaccinated, with 28% undecided or 77% of individuals who would potentially be willing to be inoculated. The main variables that explained the probability of rejection or indecision were associated with the severity of COVID-19, such as, the side effects and effectiveness of the vaccine; perceived benefits, including immunity, decreased fear of contagion, and the protection of oneself and the environment; action signals, such as, responses from ones' family and the government, available information, and specialists' recommendations; and susceptibility, including the contagion rate per 1,000 inhabitants and relatives with COVID-19, among others. Our analysis of hypothetical vaccine scenarios revealed that individuals preferred less risky vaccines in terms of fewer side effects, rather than effectiveness. Additionally, the variables that explained the indecision toward or rejection of a potential COVID-19 vaccine could be used in designing public health policies. Conclusions: We discovered that it is necessary to formulate specific, differentiated vaccination-promotion strategies for the anti-vaccine and undecided groups based on the factors that explain the probability of individuals refusing or expressing hesitation toward vaccination.

Doctors during the COVID-19 pandemic: what are their duties and what is owed to them?

Doctors form an essential part of an effective response to the COVID-19 pandemic. We argue they have a duty to participate in pandemic response due to their special skills, but these skills vary between different doctors, and their duties are constrained by other competing rights. We conclude that while doctors should be encouraged to meet the demand for medical aid in the pandemic, those who make the sacrifices and increased efforts are owed reciprocal obligations in return. When reciprocal obligations are not met, doctors are further justified in opting out of specific tasks, as long as this is proportionate to the unmet obligation.

Public Health and Risk Communication During COVID-19-Enhancing Psychological Needs to Promote Sustainable Behavior Change

Background: The current COVID-19 pandemic requires sustainable behavior change to mitigate the impact of the virus. A phenomenon which has arisen in parallel with this pandemic is an infodemic-an over-abundance of information, of which some is accurate and some is not, making it hard for people to find trustworthy and reliable guidance to make informed decisions. This infodemic has also been found to create distress and increase risks for mental health disorders, such as depression and anxiety. Aim: To propose practical guidelines for public health and risk communication that will enhance current recommendations and will cut through the infodemic, supporting accessible, reliable, actionable, and inclusive communication. The guidelines aim to support basic human psychological needs of autonomy, competence, and relatedness to support well-being and sustainable behavior change. Method: We applied the Self-Determination Theory (SDT) and concepts from psychology, philosophy and human computer interaction to better understand human behaviors and motivations and propose practical guidelines for public health communication focusing on well-being and sustainable behavior change. We then systematically searched the literature for research on health communication strategies during COVID-19 to discuss our proposed guidelines in light of the emerging literature. We illustrate the guidelines in a communication case study: wearing face-coverings. Findings: We propose five practical guidelines for public health and risk communication that will cut through the infodemic and support well-being and sustainable behavior change: (1) create an autonomy-supportive health care climate; (2) provide choice; (3) apply a bottom-up approach to communication; (4) create solidarity; (5) be transparent and acknowledge uncertainty. Conclusion: Health communication that starts by fostering well-being and basic human psychological needs has the potential to cut through the infodemic and promote effective and sustainable behavior change during such pandemics. Our guidelines provide a starting point for developing a concrete public health communication strategy.

Consumers' Fears Regarding Food Availability and Purchasing Behaviors during the COVID-19 Pandemic: The Importance of Trust and Perceived Stress

The present study aimed to investigate whether trust in circulating information and perceived stress are predictors of consumers’ fear of limited access to food as well as predictors of food purchase behaviors during the COVID-19 pandemic. The computer-assisted web interviewing (CAWI) technique was used to collect data from 1033 Polish adults in March 2020. Logistic regression was used to estimate the likelihood of fear of limited access to food and the likelihood of purchase of larger amounts of food than usual. The likelihood of experiencing fear of limited access to food increased by 16% with higher perceived stress, by 50% with higher trust in “Mass media and friends”, and by 219% with perceived changes in food availability in the previous month. Trust in “Polish government institutions” decreased the chance of experiencing such fears by 22%. The likelihood of purchasing larger quantities of food than usual increased by 9% with higher perceived stress, by 46% with higher trust in “Mass media and friends”, by 81% with perceived changes in food availability in the last month, and by 130% with fears of limited access to food as the pandemic spreads. Government institutions may have difficulty in disseminating pandemic-related recommendations through media, not only due to relatively low trust people have in media organizations but also due to the increasing likelihood of the occurrence of both fears regarding food availability and panic-stricken food-buying behaviors with increase in trust in this source of information. Therefore, it is necessary to develop interventions that will reduce perceived stress and improve the trust in information from reputable sources.

COVID-19 Amplifiers on Health Inequity Among the Older Populations

The coronavirus disease 2019 (COVID-19) is affecting the population disproportionately and is continuously widening the health gap among the population. Based on some recent studies on COVID-19 and the older population, the various cascades toward health inequity have been projected. This study highlights how the COVID-19 is met by health inequity triggers, such as global trade inequality, ageist social regulations, and the existing social inequity. While those triggers are applicable to all the populations, there seems to be specific amplifiers for health inequity among the older populations. In particular, six types of amplifiers have been identified: (1) expansion of riskscape, (2) reduction of social ties, (3) uncertainty of future, (4) losing trust in institutions, (5) coping with new knowledge, and (6) straining on public spending. While the fundamental mitigating responses to health inequity among the older population is tackling existing inequalities, this study may help to shed light on emerging vulnerabilities among the older population to alleviate far-reaching consequences of COVID-19 of the identified inequity amplifiers.

Citizen Science, Education, and Learning: Challenges and Opportunities

Citizen science is a growing field of research and practice, generating new knowledge and understanding through the collaboration of citizens in scientific research. As the field expands, it is becoming increasingly important to consider its potential to foster education and learning opportunities. Although progress has been made to support learning in citizen science projects, as well as to facilitate citizen science in formal and informal learning environments, challenges still arise. This paper identifies a number of dilemmas facing the field-from competing scientific goals and learning outcomes, differing underlying ontologies and epistemologies, diverging communication strategies, to clashing values around advocacy and activism. Although such challenges can become barriers to the successful integration of citizen science into mainstream education systems, they also serve as signposts for possible synergies and opportunities. One of the key emerging recommendations is to align educational learning outcomes with citizen science project goals at the planning stage of the project using co-creation approaches to ensure issues of accessibility and inclusivity are paramount throughout the design and implementation of every project. Only then can citizen science realise its true potential to empower citizens to take ownership of their own science education and learning.