ABSTRACT
BACKGROUND: Containment of the coronavirus disease 2019 (COVID-19) pandemic requires the public to change behavior under social distancing mandates. Social media are important information dissemination platforms that can augment traditional channels communicating public health recommendations. The objective of the study was to assess the effectiveness of COVID-19 public health messaging on Twitter when delivered by emergency physicians and containing personal narratives. METHODS: On April 30, 2020, we randomly assigned 2,007 U.S. adults to an online survey using a 2 × 2 factorial design. Participants rated one of four simulated Twitter posts varied by messenger type (emergency physician vs. federal official) and content (personal narrative vs. impersonal guidance). The main outcomes were perceived message effectiveness (35-point scale), perceived attitude effectiveness (PAE; 15-point scale), likelihood of sharing Tweets (7-point scale), and writing a letter to their governor to continue COVID-19 restrictions (write letter or none). RESULTS: The physician/personal (PP) message had the strongest effect and significantly improved all main messaging outcomes except for letter writing. Unadjusted mean differences between PP and federal/impersonal (FI) were as follows: perceived messaging effectiveness (3.2 [95% CI = 2.4 to 4.0]), PAE (1.3 [95% CI = 0.8 to 1.7]), and likelihood of sharing (0.4 [95% CI = 0.15 to 0.7]). For letter writing, PP made no significant impact compared to FI (odds ratio = 1.14 [95% CI = 0.89 to 1.46]). CONCLUSIONS: Emergency physicians sharing personal narratives on Twitter are perceived to be more effective at communicating COVID-19 health recommendations compared to federal officials sharing impersonal guidance.