Profile identification and characterization of risk perceptions and preventive behaviors during the COVID-19 pandemic: A latent profile analysis.

In a public health crisis, communication plays a vital role in making sure policies and recommendations from the government level get disseminated accurately to its people and is only considered as effective when the public accepts, supports, complies to, and engages in policies or behaves as per governments' recommendations. Adopting the multivariate audience segmentation strategy for health communication, this study uses a data-driven analytical method to (1) identify audience segments of public health crisis communication in Singapore based on knowledge, risk perception, emotional responses, and preventive behaviors; and (2) characterize each audience segment according to demographic factors, personality traits, information processing styles, and health information preferences. Results (N = 2033) from a web-based questionnaire executed in August 2021 have identified three audience segments: the less-concerned (n = 650), the risk-anxious (n = 142), and the risk-majority (n = 1,241). This study offers insights to how audiences of public health crisis communication perceive, process, and respond to information directed to them during the pandemic, thereby informing policy makers to tailor more targeted public health communication interventions in promoting positive attitude and behavior change.

Avoiding real news, believing in fake news? Investigating pathways from information overload to misbelief

This study sought to examine the potential role of news avoidance in belief in COVID-19 misinformation. Using two-wave panel survey data in Singapore, we found that information overload is associated with news fatigue as well as with difficulty in analyzing information. News fatigue and analysis paralysis also subsequently led to news avoidance, which increased belief in COVID-19 misinformation. However, this link is present only among those who are frequently exposed to misinformation about COVID-19.

Wear or Not to Wear a Mask? Recommendation Inconsistency, Government Trust and the Adoption of Protection Behaviors in Cross-Lagged TPB Models.

This study examined how exposure to government health advisories on face mask-wearing and trust in government influenced people's compliance with the advisory overtime. We conducted a three-wave panel survey (N = 1,024; T1 in February, T2 in March, T3 in April 2020) in Singapore, where the government initially enforced wearing a face mask conditional on feeling sick, and then later revised its advisory to make mask-wearing mandatory regardless of sickness. Exposure to the initial advisory at T1 had cross-lagged effects on forming positive expectancy, normative, and self-efficacy beliefs on conditional face mask-wearing at T2. Government trust at T1 also had a cross-lagged effect on increasing supportive perceived norm for conditional mask-wearing, while reducing positive expectancy of nonconditional mask-wearing at T2. Exposure to the revised advisory and government trust at T3 were positively associated with outcome expectancy, perceived norm, and self-efficacy regardless of behavior type. Regarding nonconditional mask-wearing, the autoregressive links from T2 to T3 were insignificant for perceived norm and self-efficacy and even negatively significant for intention and behavior. This study offers theoretical and practical insights by documenting the complex and dynamic processes involved in health decision-making during a novel disease pandemic.

Can Press Freedom Enhance the Effect of News Exposure on COVID-19 Health Beliefs? A Health Belief Model Perspective.

News media can influence citizens' health beliefs about COVID-19 and eventually their vaccination intention. However, existing literature has rarely investigated how such effect is contingent upon a country-level factor: press freedom. Situated in the Health Belief Model, this study draws upon a multi-national survey (N = 3,599), involving 10 major cities in Asia to address the research gap. Results showed that news exposure has a positive effect on personal health beliefs on COVID-19, affecting their vaccination intention. More interestingly, the relationship between news exposure and personal health beliefs about COVID-19 was negatively moderated by level of press freedom - that is, the relationship between news exposure and personal health beliefs is stronger in cities that belong to countries with low levels of press freedom.

Consequences of Online Misinformation on COVID-19: Two Potential Pathways and Disparity by eHealth Literacy

The COVID-19 pandemic poses an unprecedented threat to global human wellbeing, and the proliferation of online misinformation during this critical period amplifies the challenge. This study examines consequences of exposure to online misinformation about COVID-19 preventions. Using a three-wave panel survey involving 1,023 residents in Singapore, the study found that exposure to online misinformation prompts engagement in self-reported misinformed behaviors such as eating more garlic and regularly rinsing nose with saline, while discouraging evidence-based prevention behaviors such as social distancing. This study further identifies information overload and misperception on prevention as important mechanisms that link exposure to online misinformation and these outcomes. The effects of misinformation exposure differ by individuals’ eheath literacy level, suggesting the need for a health literacy education to minimize the counterproductive effects of misinformation online. This study contributes to theory-building in misinformation by addressing potential pathways of and disparity in its possible effects on behavior.

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

This study examines the emotional mechanisms of how public trust in the governments' actions to address the COVID-19 pandemic shapes individuals' risk information-seeking and avoidance. To make cross-cultural comparisons, we conducted a multi-country survey early in the pandemic in South Korea, the United States (US) and Singapore. The results suggest that trust was negatively related to fear, anger, sadness and anxiety, and positively related to hope. These emotions were significant mediators of the effect of trust on information seeking and avoidance, except for anger on avoidance. Importantly, the indirect effects of trust in government varied by country. Fear was a stronger mediator between trust and information seeking in South Korea than in the US. In contrast, sadness and anger played more prominent mediating roles in Singapore than in South Korea. This study offers theoretical insights into better understanding the roles of discrete emotions in forming information behaviors. The findings of this study also inform communication strategies that seek to navigate trust in managing pandemics that impact multiple nations.

Effects of COVID-19 Misinformation on Information Seeking, Avoidance, and Processing: A Multicountry Comparative Study

We examined the implications of exposure to misinformation about COVID-19 in the United States, South Korea, and Singapore in the early stages of the global pandemic. The online survey results showed that misinformation exposure reduced information insufficiency, which subsequently led to greater information avoidance and heuristic processing, as well as less systematic processing of COVID-19 information. Indirect effects differ by country and were stronger in the U.S. sample than in the Singapore sample. This study highlights negative consequences of misinformation during a global pandemic and addresses possible cultural and situational differences in how people interpret and respond to misinformation.

The Importance of Mandatory COVID-19 Diagnostic Testing Prior to Release from Quarantine.

A 14-day quarantine is implemented in many countries in response to the coronavirus disease pandemic. Korea implemented a mandatory quarantine for those who had close contact with infected patients and those returning from abroad. The present study explored the implications of mandatory coronavirus disease 2019 testing before releasing individuals from the 14-day quarantine in Incheon, Korea. From February 11 to July 5, 2020, 19,296 people were self-quarantined, and 56 (0.3%) of them were confirmed cases of COVID-19. Twenty (35.7%) were identified through the reporting of symptoms during quarantine, and 32 (57.1%) were identified using mandatory pre-release RT-PCR tests. Among the 32, 14 (25%) individuals reported mild symptoms and 18 (32.1%) were asymptomatic. It is suggested that mandatory diagnostic testing prior to release and the symptom-based surveillance after the 14-day quarantine may help control delayed or asymptomatic COVID-19 cases.

Coronavirus Disease Outbreak in Call Center, South Korea.

We describe the epidemiology of a coronavirus disease (COVID-19) outbreak in a call center in South Korea. We obtained information on demographic characteristics by using standardized epidemiologic investigation forms. We performed descriptive analyses and reported the results as frequencies and proportions for categoric variables. Of 1,143 persons who were tested for COVID-19, a total of 97 (8.5%, 95% CI 7.0%-10.3%) had confirmed cases. Of these, 94 were working in an 11th-floor call center with 216 employees, translating to an attack rate of 43.5% (95% CI 36.9%-50.4%). The household secondary attack rate among symptomatic case-patients was 16.2% (95% CI 11.6%- 22.0%). Of the 97 persons with confirmed COVID-19, only 4 (1.9%) remained asymptomatic within 14 days of quarantine, and none of their household contacts acquired secondary infections. Extensive contact tracing, testing all contacts, and early quarantine blocked further transmission and might be effective for containing rapid outbreaks in crowded work settings.