Public agencies tweeting the COVID-19 pandemic: cross-country comparison of must have and forgotten communication topics

IntroductionDespite the importance of national-level public health agencies in times of a pandemic, there is limited comparative understanding of their must-have and forgotten pandemic-related communication topics. MethodsTo fill this gap in the literature, this article presents an analysis of COVID-related communication topics by national-level health agencies in Italy, Sweden, and the United States using the IDEA (Internalization, Distribution, Explanation, Action) model on crisis message framing. The public health agencies included in the study are the Italian National Institute of Health (Istituto Superiore di Sanita;ISS), the Public Health Agency of Sweden (Folkhalsomyndigheten), and the Center for Disease Control and Prevention (CDC) in the US. ResultsBased on these agencies' Twitter posts (n = 856) in the first 3 months of the pandemic, the article reveals a greater attention paid to action oriented (e.g., disease prevention) and explanatory messages (e.g., disease trends) than to distribution (e.g., transmission) and internalizing messages (e.g., risk factors) in all three countries. The study also highlights differences in terms of referrals to other communication channels and communication topics, especially in terms of these agencies' emphasis on individual risk factors (related to the risk of a person suffering from serious COVID-19-related health consequences) and social risk factors (related to the chance of an individual to become infected with COVID-19 because of the social context). DiscussionThe study's findings call for better incorporation of information that is directly relevant to the receivers (internalizing messages) by public health agencies.

Evaluation of the readability, understandability, and actionability of COVID-19 public health messaging in Atlantic Canada

IntroductionEffective communication of COVID-19 information involves clear messaging to ensure that readers comprehend and can easily apply behavioral recommendations. This study evaluated the readability, understandability, and actionability of public health resources produced by the four provincial governments in Atlantic Canada (New Brunswick, Newfoundland and Labrador, Nova Scotia, and Prince Edward Island). MethodsA total of 400 web-based resources were extracted in June 2022 and evaluated using the Flesch-Kincaid Grade Level, CDC Clear Communication Index, and the Patient and Education Materials Assessment Tool. Descriptive statistics and a comparison of mean scores were conducted across provinces and type of resources (e.g., text, video). ResultsOverall, readability of resources across the region exceeded recommendations, requiring an average Grade 11 reading level. Videos and short form communication resources, including infographics, were the most understandable and actionable. Mean scores across provinces differed significantly on each tool;Newfoundland and Labrador produced materials that were most readable, understandable, and actionable, followed by New Brunswick. DiscussionRecommendations on improving clarity of COVID-19 resources are described. Careful consideration in the development of publicly available resources is necessary in supporting COVID-19 knowledge uptake, while reducing the prevalence of misinformation.

Lessons From the Pandemic: Engaging Wicked Problems With Transdisciplinary Deliberation

Some crises, such as those brought on or exposed by the COVID-19 pandemic, are wicked problems—large, complex problems with no immediate answer. As such, they make rich centerpieces for learning with respect to public deliberation and issue-based dialogue. This essay reflects on an experimental, transdisciplinary health and science communication course entitled Comprehending COVID-19. The course represents a collaborative effort among 14 faculty representing 10 different academic departments to create a resource for teaching students how to deliberate the pandemic, despite its attending, oversaturated, fake-news-infused, infodemic. We offer transdisciplinary deliberation as a pedagogical framework to expand communication repertoires in ways useful for sifting through the messiness of an infodemic while also developing key deliberation skills for productively engaging participatory decision-making with concern to wicked problems.

Toward a New Community of Care: Best Practices for Educators and Administrators During the COVID-19 Pandemic

The onset of COVID-19 left people feeling unsettled, confused, and afraid of what tomorrow may hold. As university professors specializing in health communication, we too were left with these same feelings. As health communication scholars, we focus on issues surrounding illness, risk, crisis, care, health inequities, and wellness. COVID-19 is a health crisis, yes, but it has also changed the way we operate not only in higher education but in daily life. We begin this essay with an overview of COVID-19 and its impact on students, educators, and administrators. Then, we suggest four best practices to foster a community of care in the classroom during and beyond the COVID-19 pandemic.

Intentions and Behavioural Determinants in the Face of covid-19 Pandemic: A Theory of Planned Behaviour and Risk Perception model

The containment of covid-19 implied challenges for governments and health authorities to motivate citizens to adopt several prevention behaviours (i.e., wearing a face mask and washing hands frequently). This paper aims to identify the factors that encourage people to adopt these behaviours. Our analysis was conducted over data collected by ascofapsi and the Universidad Autonoma de Barcelona about attitudes and beliefs related to the pandemic from 919 people from Colombia. The data was collected using an online snowball sampling between May and June 2020. We found that each prevention behaviour is motivated by a different set of factors. Specifically, based on the theory of planned behaviour, our results suggest that the intention to adopt a preventive behaviour is pre-dicted by a group of variables about subjective norms and attitudes as independent variables and another one linked to perceived control as mediator variables. This suggests that the motivation for prevention behaviours from authorities should be particular to each behaviour and consider the associated particular pattern of motivations and the sociodemographic characteristics and possibilities of action.

Infodemic disorder: Covid-19 and post-truth

This chapter explores the concept of infodemic, which appeared following the overabundance of information linked to the Covid-19 pandemic. The overabundance of information circulating in the media ecosystem has two main consequences: on the one hand, the selection of relevant information is problematic and therefore it is made complex for public opinion to find the right answers to its questions;on the other, the amount of information that is produced, together with its rapid circulation makes it more complex to distinguish between reliable and unreliable sources, producing the risk of informations "pollution" and increasing the risk of coming across false or misleading information. © Springer Nature Switzerland AG 2023. All rights reserved.

A case study of using natural language processing to extract consumer insights from tweets in American cities for public health crises.

BACKGROUND: The COVID-19 pandemic was a "wake up" call for public health agencies. Often, these agencies are ill-prepared to communicate with target audiences clearly and effectively for community-level activations and safety operations. The obstacle is a lack of data-driven approaches to obtaining insights from local community stakeholders. Thus, this study suggests a focus on listening at local levels given the abundance of geo-marked data and presents a methodological solution to extracting consumer insights from unstructured text data for health communication. METHODS: This study demonstrates how to combine human and Natural Language Processing (NLP) machine analyses to reliably extract meaningful consumer insights from tweets about COVID and the vaccine. This case study employed Latent Dirichlet Allocation (LDA) topic modeling, Bidirectional Encoder Representations from Transformers (BERT) emotion analysis, and human textual analysis and examined 180,128 tweets scraped by Twitter Application Programming Interface's (API) keyword function from January 2020 to June 2021. The samples came from four medium-sized American cities with larger populations of people of color. RESULTS: The NLP method discovered four topic trends: "COVID Vaccines," "Politics," "Mitigation Measures," and "Community/Local Issues," and emotion changes over time. The human textual analysis profiled the discussions in the selected four markets to add some depth to our understanding of the uniqueness of the different challenges experienced. CONCLUSIONS: This study ultimately demonstrates that our method used here could efficiently reduce a large amount of community feedback (e.g., tweets, social media data) by NLP and ensure contextualization and richness with human interpretation. Recommendations on communicating vaccination are offered based on the findings: (1) the strategic objective should be empowering the public; (2) the message should have local relevance; and, (3) communication needs to be timely.

Unintended consequences of communicating rapid COVID-19 vaccine policy changes- a qualitative study of health policy communication in Ontario, Canada.

BACKGROUND: The success of the COVID-19 vaccination roll-out depended on clear policy communication and guidance to promote and facilitate vaccine uptake. The rapidly evolving pandemic circumstances led to many vaccine policy amendments. The impact of changing policy on effective vaccine communication and its influence in terms of societal response to vaccine promotion are underexplored; this qualitative research addresses that gap within the extant literature. METHODS: Policy communicators and community leaders from urban and rural Ontario participated in semi-structured interviews (N = 29) to explore their experiences of COVID-19 vaccine policy communication. Thematic analysis was used to produce representative themes. RESULTS: Analysis showed rapidly changing policy was a barrier to smooth communication and COVID-19 vaccine roll-out. Continual amendments had unintended consequences, stimulating confusion, disrupting community outreach efforts and interrupting vaccine implementation. Policy changes were most disruptive to logistical planning and community engagement work, including community outreach, communicating eligibility criteria, and providing translated vaccine information to diverse communities. CONCLUSIONS: Vaccine policy changes that allow for prioritized access can have the unintended consequence of limiting communities' access to information that supports decision making. Rapidly evolving circumstances require a balance between adjusting policy and maintaining simple, consistent public health messages that can readily be translated into action. Information access is a factor in health inequality that needs addressing alongside access to vaccines.

From COVID-19 Vaccine Hesitancy to Vaccine Acceptance: Results of a Longitudinal Survey.

OBJECTIVES: COVID-19 vaccines are widely available, but uptake is suboptimal. To develop strategies to increase vaccination rates, we sought to (1) characterize adults initially hesitant to be vaccinated for COVID-19 who later received the vaccine and (2) identify factors associated with their vaccination decision. METHODS: In January 2021, we conducted an online survey of US adults via Prolific that assessed vaccination intent, COVID-19-related knowledge and attitudes, and demographic characteristics. In May 2021, we recontacted respondents to assess vaccination status and factors influencing their vaccination decision. We used χ2 statistics and t tests to examine associations between respondents' vaccination status and their characteristics, knowledge, and attitudes. We analyzed reasons for vaccination using thematic analysis. RESULTS: Of 756 initially vaccine-hesitant respondents, 529 (70.0%) completed the follow-up survey. Nearly half of those initially not sure about vaccination (47.3%, 112 of 237) were vaccinated at follow-up, while 21.2% (62 of 292) of those initially planning not to be vaccinated were vaccinated at follow-up. Of those initially not sure, higher educational attainment, greater knowledge of COVID-19, and a doctor's recommendation were associated with vaccination. Of those initially intending not to be vaccinated, male sex, Democratic political affiliation, receipt of an influenza shot within 5 years, being more worried about COVID-19, and having greater COVID-19 knowledge were associated with increased likelihood of being vaccinated. Of 167 respondents who gave reasons for vaccination, protecting oneself and others (59.9%), practical issues (29.9%), social influences (17.4%), and vaccine safety (13.8%) were the main reasons. CONCLUSION: Providing information on the protective value of vaccination, implementing rules that make remaining unvaccinated burdensome, making vaccination easy, and providing social support may influence vaccine-hesitant adults to accept vaccination.

An Entertainment-Education Video and Written Messages to Alleviate Loneliness in Germany: Pilot Randomized Controlled Study.

BACKGROUND: More than half of adults in Germany have felt lonely during the COVID-19 pandemic. Previous studies highlight the importance of boosting positive emotions and social connectedness to combat loneliness. However, interventions targeting these protective psychosocial resources remain largely untested. OBJECTIVE: In this study, we aim to test the feasibility of a short animated storytelling video, written messages boosting social connectedness, and a combination of both for alleviating loneliness. METHODS: We enrolled 252 participants who were 18 years or older and spoke fluent German. Participants were recruited from a previous study on loneliness in Germany. We measured the effects of a combination of an animated video and written messages (intervention A), an animated video (intervention B), and written messages (intervention C) on loneliness, self-esteem, self-efficacy, and hope. We compared these with a control arm, which did not receive any intervention. The animated video was developed by Stanford University School of Medicine to reflect experiences of social isolation during the COVID-19 pandemic and convey messages of hope and solidarity. The written messages communicate four findings from recent studies on loneliness in Germany: (1) over a period of 6 months, 66% of respondents in Germany reported feeling lonely (feelings of loneliness are surprisingly common); (2) physical activity can ease feelings of loneliness; (3) focusing on "what really matters" in one's life can help to ease feelings of loneliness; and (4) turning to friends for companionship and support can ease feelings of loneliness. Participants were randomized 1:1:1:1 to interventions A, B, C, and the control condition, using the randomization feature of the web-based platform "Unipark," on which our trial takes place. Both the study investigators and analysts were blinded to the trial assignments. The primary outcome, loneliness, was measured using the short-form UCLA Loneliness Scale (ULS-8). Our secondary outcomes included the scores of the Coping with Loneliness Questionnaire, the 10-item Rosenberg Self-Esteem Scale (RSE), the 10-item General Self-Efficacy Scale, and the 12-item Adult Hope Scale (AHS). RESULTS: We observed no statistically significant effect of the tested interventions on loneliness scores, controlling for the baseline loneliness score before an intervention (all P values >.11). However, we observed significantly greater intention to cope with loneliness after exposure to an animated video when compared with the control (ß=4.14; t248=1.74; 1-tailed P=.04). CONCLUSIONS: Our results provide meaningful evidence for the feasibility of a full-scale study. Our study sheds light on the intention to cope with loneliness and explores the potential for creative digital interventions to enhance this psychological precursor, which is integral to overcoming loneliness. TRIAL REGISTRATION: German Clinical Trials Register DRKS00027116; https://drks.de/search/en/trial/DRKS00027116.

Linguistic Methodologies to Surveil the Leading Causes of Mortality: Scoping Review of Twitter for Public Health Data.

BACKGROUND: Twitter has become a dominant source of public health data and a widely used method to investigate and understand public health-related issues internationally. By leveraging big data methodologies to mine Twitter for health-related data at the individual and community levels, scientists can use the data as a rapid and less expensive source for both epidemiological surveillance and studies on human behavior. However, limited reviews have focused on novel applications of language analyses that examine human health and behavior and the surveillance of several emerging diseases, chronic conditions, and risky behaviors. OBJECTIVE: The primary focus of this scoping review was to provide a comprehensive overview of relevant studies that have used Twitter as a data source in public health research to analyze users' tweets to identify and understand physical and mental health conditions and remotely monitor the leading causes of mortality related to emerging disease epidemics, chronic diseases, and risk behaviors. METHODS: A literature search strategy following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extended guidelines for scoping reviews was used to search specific keywords on Twitter and public health on 5 databases: Web of Science, PubMed, CINAHL, PsycINFO, and Google Scholar. We reviewed the literature comprising peer-reviewed empirical research articles that included original research published in English-language journals between 2008 and 2021. Key information on Twitter data being leveraged for analyzing user language to study physical and mental health and public health surveillance was extracted. RESULTS: A total of 38 articles that focused primarily on Twitter as a data source met the inclusion criteria for review. In total, two themes emerged from the literature: (1) language analysis to identify health threats and physical and mental health understandings about people and societies and (2) public health surveillance related to leading causes of mortality, primarily representing 3 categories (ie, respiratory infections, cardiovascular disease, and COVID-19). The findings suggest that Twitter language data can be mined to detect mental health conditions, disease surveillance, and death rates; identify heart-related content; show how health-related information is shared and discussed; and provide access to users' opinions and feelings. CONCLUSIONS: Twitter analysis shows promise in the field of public health communication and surveillance. It may be essential to use Twitter to supplement more conventional public health surveillance approaches. Twitter can potentially fortify researchers' ability to collect data in a timely way and improve the early identification of potential health threats. Twitter can also help identify subtle signals in language for understanding physical and mental health conditions.

The 2022 ParticipACTION Report Card on Physical Activity for Children and Youth: Focus on the COVID-19 pandemic impact and equity-deserving groups.

Introduction: The ParticipACTION Report Card on Physical Activity for Children and Youth is the most comprehensive national assessment of physical activity and related behaviors, characteristics, and opportunities for children and youth. The 2022 Report Card assigned grades based on data gathered during the COVID-19 pandemic to reflect this extraordinary time-period in Canada. Further, while not graded, efforts were made to summarize key findings for early years children and those identifying as: having a disability, Indigenous, 2SLGBTQ+, newcomers to Canada, racialized, or girls. The purpose of this paper is to summarize the 2022 ParticipACTION Report Card on Physical Activity for Children and Youth. Methods: The best available physical activity data captured during the whole COVID-19 pandemic was synthesized across 14 different indicators in four categories. The 2022 Report Card Research Committee assigned letter grades (i.e., A-F) based on expert consensus of the evidence. Synthesis: Grades were assigned for: Daily Behaviors (Overall Physical Activity: D; Active Play: D-; Active Transportation: C-; Organized Sport: C+; Physical Education: Incomplete [INC]; Sedentary Behaviors: F; Sleep: B; 24-Hour Movement Behaviors: F), Individual Characteristics (Physical Literacy: INC; Physical Fitness: INC), Spaces and Places (Household: C, School: B-, Community and Environment: B), and Strategies and Investments (Government: B-). Compared to the 2020 Report Card, the COVID-19 specific grades increased for Active Play and Active Transportation; and decreased for Overall Physical Activity, Sedentary Behaviors, Organized Sport, and Community and Environment. There were many data gaps for equity-deserving groups. Conclusion: During the COVID-19 pandemic, the grade for Overall Physical Activity decreased from a D+ (2020) to a D, coinciding with decreases in grades reflecting fewer opportunities for sport and community/facility-based activities as well as higher levels of sedentary behaviors. Fortunately, improvements in Active Transportation and Active Play during COVID-19 prevented a worse shift in children's health behaviors. Efforts are needed to improve physical activity for children and youth during and post-pandemic, with a greater emphasis on equity-deserving groups.

Frequent hospital presenters' use of health information during COVID-19: results of a cross-sectional survey.

BACKGROUND: High-frequency hospital users often present with chronic and complex health conditions and are at increased risk of serious morbidity and mortality if they contract COVID-19. Understanding where high-frequency hospital users are sourcing their information, whether they understand what they find, and how they apply the information to prevent the spread of COVID-19 is essential for health authorities to be able to target communication approaches. METHODS: Cross-sectional survey of 200 frequent hospital users (115 with limited English proficiency) informed by the WHO's "Rapid, simple, flexible behavioral insights on COVID-19". Outcome measures were source of, and trust in information, and knowledge of symptoms, preventive strategies, restrictions, and identification of misinformation. RESULTS: The most frequently cited source of information was television (n = 144, 72%) followed by the internet (n = 84, 42%). One in four television users sought their information from overseas news outlets from their country of origin, while for those using the internet, 56% relied on Facebook and other forms of social media including YouTube and WeChat. Overall, 41.2% of those surveyed had inadequate knowledge about symptoms, 35.8% had inadequate knowledge about preventative strategies, 30.2% had inadequate knowledge about government-imposed restrictions, and 69% believed in misinformation. Half of the respondents (50%) trusted all information, and only one in five (20%) were uncertain or untrusting. English-speaking participants were almost three times more likely to have adequate knowledge about symptoms (OR 2.69, 95%CI 1.47;4.91) and imposed restrictions (OR 2.10 95%CI 1.06; 4.19), and 11 times more likely to recognize misinformation (OR 11.52 95%CI 5.39; 24.60) than those with limited English. CONCLUSION: Within this population of high-frequency hospital users with complex and chronic conditions, many were sourcing their information from less trustworthy or locally relevant sources, including social media and overseas news outlets. Despite this, at least half were trusting all the information that they found. Speaking a language other than English was a much greater risk factor for having inadequate knowledge about COVID-19 and believing in misinformation. Health authorities must look for methods to engage diverse communities, and tailor health messaging and education in order to reduce disparities in health outcomes.

When Right-Wing Populism Becomes Distorted Public Health Communication: Tracing the Roots of Jair Bolsonaro's Epidemiological Denialism

This article delineates key links between right-wing populism and epidemiological denialism. Building on a comparative analysis of central tropes from Brazilian president Jair Bolsonaro's 2018 campaign and his public-facing response to the COVID-19 pandemic, we argue that his engagement during both periods employs two key elements of right-wing populism: Antielitism, or the view that the political establishment is irredeemably disconnected from the citizenry, and anti-pluralism, or the blaming of political and social problems on scapegoat populations. During the COVID-19 outbreak, this denigration of public trust fuels denialism or the systemic attempt to downplay severity to minimize public response. Developing a thematic analysis around Bolsonaro's speeches, interviews, and personal social media, we address how anti-elitist and anti-pluralist strategies from the 2018 campaign inform the pandemic response. These include the discrediting of governmental bodies, the villainization of progressive activists, and the assignation of blame on foreign actors. Our goal is to provide an in-depth case study of how communication bolstering epidemiological denialism is propagated-an increasingly vital conversation as right-wing populism and health misinformation proliferate.

Thinning the Herd: COVID-19 and the Rhetoric of Trumpian Catastrophe

As COVID-19 infections spread in early 2020, the term herd immunity drew the Trump administration's attention as a remedy for redressing the pandemic. However, scientific experts warned the Trump administration against adopting herd immunity as a pandemic response. The Trump administration was unmoved. I argue that understanding the Trump administration's incongruous pandemic response is impossible without theorizing the deeper catastrophic formations uniting herd immunity and the political Right. Drawing evidence from the Trump administration and its allies, I analyze herd immunity as a reflection of a catastrophic form of social Darwinism emerging from the Trump administration's coronavirus messaging. By exploring the Trump administration's general enthusiasm for catastrophe, I offer a fresh scholarly contribution at the intersection of rhetorical studies, public address, and health, political, and scientific communication, ultimately illuminating larger theoretical and political lessons for the discipline and beyond.

The WHO?s communication strategies on social media during the early stage of the 2021 COVID vaccination campaign

The crisis caused by COVID-19 forced public and private actors to deploy various strategies on social media to communicate effectively with their public. This research analyses the institutional communication of the World Health Organization's Twitter account during the first quarter of 2021, with the aim of shedding light on their strategy and analyzing both its strengths and the areas with room for improvement in a crisis like the one studied. For this purpose, an ethnographic content analysis was run on the tweets published by the institutional account of the WHO and the responses issued by the public. A computer-assisted analysis was undertaken through two software programs (SPSS 27 and NVivo 11), and an online tool, Onodo - that helped us develop a sociogram with the different relationships between the actors involved in the crisis and risk communication of the WHO around the subject of vaccination. The main results show, on the one hand, that vaccination is not the focal point of the WHO's discourse at a time when the public's interest was centered on said thematic axis, and on the other, that the or-ganization was not able to create an effective dialogic space. Considering these findings, a reflection is encouraged to optimize professional praxis in future risk and crisis communication strategies in digital environments, expanding the scope of this study towards other organizations and/or time frames.

A Web-Based Public Health Intervention for Addressing Vaccine Misinformation: Analysis of Learner Engagement and Shift in Hesitancy to Vaccinate.

Web-based public health interventions can be a useful tool for disseminating evidence-based information to the public. However, completion rates are traditionally low, and misinformation often travels at a faster pace than evidence-based sources. This study describes the design of a web-based public health intervention to address COVID-19 vaccine hesitancy. A quasi-experimental approach was used in which a validated instrument, the Adult Vaccine Hesitancy Survey, was given to learners both pre and post intervention to observe any change in attitude towards vaccination. Our pilot observed a small positive shift in vaccine hesitancy and experienced higher than average completion rates. By integrating motivational learning design into public health interventions we increase the likelihood that learners finish the entire intervention, creating greater chance for positive behavior change.

COVID-19 Infodemic and Impacts on the Mental Health of Older People: Cross-sectional Multicenter Survey Study.

BACKGROUND: The COVID-19 pandemic received widespread media coverage due to its novelty, an early lack of data, and the rapid rise in deaths and cases. This excessive coverage created a secondary "infodemic" that was considered to be a serious public and mental health problem by the World Health Organization and the international scientific community. The infodemic particularly affected older individuals, specifically those who are vulnerable to misinformation due to political positions, low interpretive and critical analysis capacity, and limited technical-scientific knowledge. Thus, it is important to understand older people's reaction to COVID-19 information disseminated by the media and the effect on their lives and mental health. OBJECTIVE: We aimed to describe the profile of exposure to COVID-19 information among older Brazilian individuals and the impact on their mental health, perceived stress, and the presence of generalized anxiety disorder (GAD). METHODS: This cross-sectional, exploratory study surveyed 3307 older Brazilians via the web, social networks, and email between July 2020 and March 2021. Descriptive analysis and bivariate analysis were performed to estimate associations of interest. RESULTS: Major proportions of the 3307 participants were aged 60 to 64 years (n=1285, 38.9%), female (n=2250, 68.4%), and married (n=1835, 55.5%) and self-identified as White (n=2364, 71.5%). Only 295 (8.9%) had never started or completed a basic education. COVID-19 information was mainly accessed on television (n=2680, 81.1%) and social networks (n=1943, 58.8%). Television exposure was ≥3 hours in 1301 (39.3%) participants, social network use was 2 to 5 hours in 1084 (32.8%) participants, and radio exposure was ≥1 hour in 1223 (37%) participants. Frequency of exposure to social networks was significantly associated with perceived stress (P=.04) and GAD (P=.01). A Bonferroni post hoc test revealed significantly different perceived stress in participants who were exposed to social networks for 1 hour (P=.04) and those who had no exposure (P=.04). A crude linear regression showed that "some" social media use (P=.02) and 1 hour of exposure to social media (P<.001) were associated with perceived stress. Adjusting for sociodemographic variables revealed no associations with this outcome variable. In a crude logistic regression, some social media use (P<.001) and 2 to 5 hours of exposure to social media (P=.03) were associated with GAD. Adjusting for the indicated variables showed that some social network use (P<.001) and 1 hour (P=.04) and 2 to 5 hours (P=.03) of exposure to social media were associated with GAD. CONCLUSIONS: Older people, especially women, were often exposed to COVID-19-related information through television and social networks; this affected their mental health, specifically GAD and stress. Thus, the impact of the infodemic should be considered during anamnesis for older people, so that they can share their feelings about it and receive appropriate psychosocial care.

Media Consumption and COVID-19-Related Precautionary Behaviors During the Early Pandemic: Survey Study of Older Adults.

BACKGROUND: During the COVID-19 pandemic, media sources dedicated significant time and resources to improve knowledge of COVID-19 precautionary behaviors (eg, wearing a mask). Many older adults report using the television, radio, print newspapers, or web-based sources to get information on political news, yet little is known about whether consuming news in the early phase of the pandemic led to behavior change, particularly in older adults. OBJECTIVE: The goals of this study were to determine (1) whether dosage of news consumption on the COVID-19 pandemic was associated with COVID-19 precautionary behaviors; (2) whether being an ever-user of social media was associated with engagement in COVID-19 precautionary behaviors; and (3) among social media users, whether change in social media use during the early stages of the pandemic was associated with engagement in COVID-19 precautionary behaviors. METHODS: Data were obtained from a University of Florida-administered study conducted in May and June of 2020. Linear regression models were used to assess the association between traditional news and social media use on COVID-19 precautionary behaviors (eg, mask wearing, hand washing, and social distancing behaviors). Analyses were adjusted for demographic characteristics, including age, sex, marital status, and education level. RESULTS: In a sample of 1082 older adults (mean age 73, IQR 68-78 years; 615/1082, 56.8% female), reporting 0 and <1 hour per day of media consumption, relative to >3 hours per day, was associated with lower engagement in COVID-19 precautionary behaviors in models adjusted for demographic characteristics (ß=-2.00; P<.001 and ß=-.41; P=.01, respectively). In addition, increasing social media use (relative to unchanged use) was associated with engagement in more COVID-19 precautionary behaviors (ß=.70, P<.001). No associations were found between being an ever-user of social media and engaging in COVID-19 precautionary behaviors. CONCLUSIONS: The results demonstrated an association between higher media consumption and greater engagement in COVID-19 precautionary behaviors in older adults. These findings suggest that media can be effectively used as a public health tool for communication of prevention strategies and best practices during future health threats, even among populations who are historically less engaged in certain types of media.

Effect of Multimedia E-Book Use on the Information Literacy of Nursing Students and Health Communication in Student-Led Large- and Small-Group Community Health Education Sessions

The integration of digital technology into healthcare is critical for health communication. This study analyzed a group of nursing students who applied multimedia health education e-books to different groups of varying sizes to explore the efficiency of implementing health communication and nursing information literacy in the nursing industry. If medical personnel can make appropriate use of technology, combine medical operations with information systems, and disseminate the purpose of health to groups of different sizes properly, the quality of patient care will improve. Thirty-two junior nursing students at the college level were divided into three groups, each subject to a 3-week internship. After the internship, a questionnaire survey was conducted. Additionally, nine nursing students were interviewed in a 45-min semistructured format. Regarding the effectiveness of nursing students using multimedia e-books to implement health communication and the development of nursing information literacy, the statistical analysis results demonstrated no significant differences between large groups and small groups. However, their 5-point Likert scale average values were all greater than 4, indicating that regardless of group size, their feedback on using e-books was positive. This means multimedia e-books can effectively help nursing students practice health communication application effectiveness and develop nursing information literacy.