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.

COVID-19 communication management in Europe: a comparative analysis of the effect of information-seeking in the public's sense-making in Italy, Spain and the United Kingdom

PurposeGovernments around the world have shown poor capabilities in responding effectively to the COVID-19 health emergency outbreaks. After the declaration of COVID-19 as an international pandemic by the World Health Organization on January 31, 2020, three countries experienced the greatest initial impact in Europe. Sequentially Italy, Spain and the United Kingdom (UK) were hit by the highest numbers of contagion and death in the first few months in Europe. The aim of this paper is to assess how information channels and sources influenced the public's evaluation of the three government's communication response strategies.Design/methodology/approachAn online survey was conducted between March 14 and April 14, 2020, during the first wave of lockdowns and declarations of States of Emergency in the three countries.FindingsFindings show particularities for the different countries, but also similarities in response and reactions of the public in the three scenarios. The response strategy of the UK Government was the most untrusted and criticized by citizens. In contrast, the Italian and Spanish Governments, which both chose to respond with the severest restrictions, attracted more support from citizens, especially in Italy, which was the first to close borders and impose lockdowns for the population.Research limitations/implicationsDespite the national differences in the preference of information channels and sources, overall, an empirical relationship between government communication assessment and media use were found in all the scenarios.Practical implicationsThis empirical study has theoretical and practical implications. Theoretically, findings will add evidence of implications of the Channel Complementary Theory to the field of risk, crisis and emergency communication. The results also provide insights for communication practitioners in the public sector on how forms of information and trust in sources influence the public's assessment of authorities' communication.Originality/valueImplications for theory and empirical research about communication during a health pandemic are identified and discussed.

Communicating for the Safe Use of Medicines: Progress and Directions for the 2020s Promoted by the Special Interest Group of the International Society of Pharmacovigilance: An International Journal of Medical Toxicology and Drug Experience

Bahri et al discuss the International Society of Pharmacovigilance's (ISoP) Special Interest Group on Medicinal Product Risk Communication (CommSIG). ISoP dedicated a range of activities to communication about the risks and safe use of medicines in the decade before creating the CommSIG, including a pre-conference training course in Tianjin in 2014. Establishing the CommSIG also built on a forward-looking attitude to changes in medicine, communication technology, patient expectations, and societies overall. It was also recognized that the multidisciplinary approach to communication would support reaching out to patient groups, healthcare, medicine information and media professionals, and experts from the communication, social, healthcare and data sciences. The nine founding members of the CommSIG published its background and aspirations in ISoP's official journal, Drug Safety.

"No more COVID-19 messages via social media, please": the mediating role of COVID-19 message fatigue between information overload, message avoidance, and behavioral intention.

Employing the stressor-strain-outcome framework, this study demonstrates that COVID-19 information overload on social media exerts a significant effect on the level of fatigue toward COVID-19-related messages. This feeling of message fatigue also makes people avoid another exposure to similar types of messages while diminishing their intentions to adopt protective behaviors in response to the pandemic. Information overload regarding COVID-19 on social media also has indirect effects on message avoidance and protective behavioral intention against COVID-19, respectively, through the feeling of fatigue toward COVID-19 messages on social media. This study emphasizes the need to consider message fatigue as a significant barrier in delivering effective risk communication.

Biocidal products: Opportunities in risk assessment, management, and communication.

In the coronavirus disease 2019 era, biocidal products are increasingly used for controlling harmful organisms, including microorganisms. However, assuring safety against adverse health effects is a critical issue from a public health standpoint. This study aimed to provide an overview of key aspects of risk assessment, management, and communication that ensure the safety of biocidal active ingredients and products. The inherent characteristics of biocidal products make them effective against pests and pathogens; however, they also possess potential toxicities. Therefore, public awareness regarding both the beneficial and potential adverse effects of biocidal products needs to be increased. Biocidal active ingredients and products are regulated under specific laws: the Federal Insecticide, Fungicide, and Rodenticide Act for the United States; the European Union (EU) Biocidal Products Regulation for the EU; and the Consumer Chemical Products and Biocide Safety Management Act for the Republic of Korea. Risk management also needs to consider the evidence of enhanced sensitivity to toxicities in individuals with chronic diseases, given the increased prevalence of these conditions in the population. This is particularly important for post-marketing safety assessments of biocidal products. Risk communication conveys information, including potential risks and risk-reduction measures, aimed at managing or controlling health or environmental risks. Taken together, the collaborative effort of stakeholders in risk assessment, management, and communication strategies is critical to ensuring the safety of biocidal products sold in the market as these strategies are constantly evolving.

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.

Reputation management during a public health crisis: Overcompensating when all else fails

Although reactions to reputational threats have been studied before, there is still an opportunity to understand the dynamics of reputation management facing a crisis. This study seeks to understand how the legal-procedural, moral, performative, and technical dimensions of reputation change during the management of an extended crisis in a public health organization. We explore the communication of the Mexican Health Secretariat by analyzing its press conferences and releases before and during the COVID-19 pandemic. Building on the situational crisis communication theory and considering public interest, we conducted two exploratory examinations based on text-as-data methods to capture reputation-related language. Our analysis suggests that factors influencing reputational threat, such as crisis severity, legitimacy, leaders' individual reputation, and coalition support, may be important for choosing between strategies. We argue that the Secretariat radically changed its reputation management strategy during the pandemic-they first stressed the technical and, as damage rose, the performative dimensions.

Covering conflicts and risks: Chinese newspapers' peace-loving discourse and their use of risk language

The process through which people and society begin to see and frame something as risky is complex. As risk communication practitioners play a critical role in fostering real-world risk governance, this study emphasizes the performative role of language in mobilizing symbolic resources to build and control risks from a communication standpoint. Critical discourse analysis (CDA) was used to reveal patterns of how two events - the COVID-19 pandemic and the Russia-Ukraine dispute - were covered by the Chinese media, and speculate about the relationship between risk communication practice and its wider geopolitical context. Results revealed different frames were used for the two events, and that 'threat' was most frequently used when addressing the Russia-Ukraine dispute, whereas 'risk' was adopted for most COVID-19-related articles. Two themes were generated when interpreting the discourse through a critical geopolitical approach: 'From the COVID-19 Approach to the Political Systems' and 'China as a global Player through its peaceful Rise'. While China prefers to maintain peace in its interaction with other global actors, the Chinese government does not simply accept adversity, particularly when it comes to geopolitical conflicts derived from arbitrary ideological disagreements. The study adds to the current literature on the relationship between the practice and context of risk communication, as well as to the underrepresented regional online news coverage of risks and conflicts that focus on China.

Chinese travellers' mobility decision-making processes during public health crisis situations: a Bayesian network model

Travellers' mobility decisions are fraught with uncertainty and instability during public health crises. However, existing studies have not revealed the internal mechanism of travellers' mobility changes in a public health crisis. This paper established and trained a Bayesian network model from multiple data to analyse Chinese travellers' mobility decision-making processes under COVID-19 and simulated the changes in mobility decisions in different scenarios. The results show that travellers reformulate mobility decisions in response to various information and negotiate between social customs and personal needs. Mobility can be modified through risk communication and habits adaptation. Bayesian network models provide a methodological contribution to causal exploration and scenario prediction.

Scenario-based messages on social media motivate COVID-19 information seeking

Communicating information about health risks empowers individuals to make informed decisions. To identify effective communication strategies, we manipulated the specificity, self-relevance, and emotional framing of messages designed to motivate information seeking about COVID-19 exposure risk. In Study 1 (N = 221,829), we conducted a large-scale social media field study. Using Facebook advertisements, we targeted users by age and political attitudes. Episodic specificity drove engagement: Advertisements that contextualized risk in specific scenarios produced the highest click-through rates, across all demographic groups. In Study 2, we replicated and extended our findings in an online experiment (N = 4,233). Message specificity (but not self-relevance or emotional valence) drove interest in learning about COVID-19 risks. Across both studies, we found that older adults and liberals were more interested in learning about COVID-19 risks. However, message specificity increased engagement across demographic groups. Overall, evoking specific scenarios motivated information seeking about COVID-19, facilitating risk communication to a broad audience. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement Throughout the COVID-19 pandemic, individuals have weighed risks and benefits when making choices about everyday activities. Learning about the current local risk of COVID-19 exposure is important for making informed decisions. Social media can be a platform for rapidly disseminating health information, but it can also contribute to misinformation and confirmation bias. Here, we tested strategies for risk communication on social media, targeting users by age and political attitudes. In Study 1, we used Facebook advertisements to motivate users to learn about COVID-19 exposure risk. Users who clicked on an ad were directed to interactive risk assessment tools on a public website. We varied the specificity of the advertisements by describing national ("in the United States"), local ("in your area"), or scenario ("at your favorite restaurant") risks. We also manipulated emotional valence by using positive ("stay safe and healthy") or negative ("avoid danger and illness") language. Specificity drove engagement: In all demographic groups, users were the most likely to click on scenario ads. In Study 2, we replicated and extended our findings in a sample of paid participants. In addition to varying the specificity and valence of the ads, we manipulated self-relevance (e.g., "a restaurant" vs. "your favorite restaurant") and tested an alternative scenario (grocery store instead of restaurant). Consistent with Study 1, specificity (but not valence or self-relevance) drove interest in learning about COVID-19 risk. In both studies, we also found that older adults and liberals were more interested in COVID-19 information, whereas conservatives were less engaged and more likely to feel angry or disgusted. However, scenario ads reliably increased engagement across demographic groups. Overall, we found that evoking specific scenarios motivated information seeking about COVID-19 risks. Health messages with improved specificity can be readily disseminated on social media, reaching a broad audience to support public health goals. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The Mediation Effects of COVID Vaccine Anxiety, Safety, and Fear on the Relationships between COVID-19 Threat and Efficacy Levels with Parents' Intent to Vaccinate Children

Given the updated, ongoing recommendations for the COVID vaccine series and booster for children ages 6 months and older yet vaccine coverage remaining at less than 50% among children, it is critical for public health communicators to understand sources of vaccine hesitance among parents. A national survey of parents identifies the mediating effects of vaccine anxiety, safety, and fear on the relationships between COVID-19 threat and efficacy with behavioral intentions to vaccinate. Anxiety mediated the relationships between both threat and efficacy with parents'behavioral intentions to vaccinate their children. Vaccine anxiety, safety, and fear mediated parents' decisions to vaccinate themselves. Theoretical and applied implications are reviewed. Copyright 2023 Authors.

CRISIS & EMERGENCY RISK COMMUNICATION: Six Principles for OSH Professionals

[...]as of this writing, the last complete revision to the CDC's CERC framework took place in 2014, and the last update to the web page where it is housed was in 2018 (CDC, 2018a). While OSH professionals may not find themselves as the face of a response effort, their subject matter expertise is essential to helping their organizations identify potential hazards and implement appropriate controls using effective communication (CDC, 2018b;Loon, 2020). [...]it is critical for OSH professionals to apply these six principles of CERC to remain accurate, credible and timely in their risk communication. In situations such as serious injuries and fatalities, extreme weather events, environmental or property damage, or even infectious disease outbreaks, OSH professionals are well positioned to be the source of immediate subject matter expertise even if the situation is not fully understood. [...]while establishing their position as the first to present the information relevant to their subject matter expertise, OSH professionals must accurately present what is known, what is not known and the processes in place to fill any knowledge gaps (CDC, 2018b).

Defense in depth and risk communication: Contributions from social psychology to large-scale infectious diseases

The novel coronavirus disease (COVID-19) pandemic that occurred suddenly at the beginning of 2020 has had a significant and multifaceted impact on the economy, society, civilian life, and culture, as well as the human mind. For this reason, it is essential to establish a collaborative system that includes medical science, which has been the subject of much discussion, as well as the natural sciences, the humanities, and social sciences to evaluate the impact of COVID-19. This paper focuses on defense in depth and risk communication and discusses the issues caused by COVID-19 from the perspectives of social psychology and risk studies, both of which have an inherent interdisciplinary nature. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Knowledge, perceptions and preventive practices towards COVID-19 early in the outbreak among Jimma university medical center visitors, Southwest Ethiopia

Background Novel-coronavirus disease-2019 (COVID-19) is currently a pandemic and public health emergency of international concern, as avowed by the World Health Organization (WHO). Ethiopia has become one of the affected countries as of March 15, 2020. Objective This study aimed to assess the knowledge, perceptions, and practices among the Jimma University medical center (JUMC) visitors in Jimma town. Methods A cross-sectional study was conducted on 247 sampled visitors, from 20–24 March 2020. Consecutive sampling was used to recruit the participants. The study tools were adapted from WHO resources. The data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Descriptive statistics were used to describe the status of knowledge, perception, and practices. Logistic regression was executed to assess the predictors of dominant preventive practices. Results Of the 247 respondents, 205 (83.0%) knew the main clinical symptoms of COVID-19. 72.0% knew that older people who have chronic illnesses are at high risk of developing a severe form of COVID-19. About 95.1% knew that the COVID-19 virus spreads via respiratory droplets of infected people, while 77 (31.2%) of the respondents knew about the possibility of asymptomatic transmission. Only 15 (6.1%) knew that children and young adults had to involve preventive measures. Overall, 41.3% of the visitors had high knowledge. The majority, 170(68.8%), felt self-efficacious to controlling COVID-19. 207(83.3%) believed that COVID-19 is a stigmatized disease. Frequent hand washing (77.3%) and avoidance of shaking hands (53.8%) were the dominant practices. Knowledge status and self-efficacy (positively), older age, and unemployment (negatively) predicted hand washing and avoidance of handshaking. Conclusions The status of knowledge and desirable practices were not sufficient enough to combat this rapidly spreading virus. COVID-19 risk communication and public education efforts should focus on building an appropriate level of knowledge while enhancing the adoption of recommended self-care practices with special emphasis on high-risk audience segments.

Sentiment Impact of Public Health Agency communication Strategies on TikTok under COVID-19 Normalization: Deep Learning Exploration.

Aim: The accessibility of social media data has allowed researchers to measure official-public interactions during COVID-19. However, previous work analyzing official posts or public comments has failed to explore the link between the two. Therefore, this study investigates the relationship between the communication strategies of public health agencies (PHAs) on TikTok and public emotional/sentiment tendencies in COVID-19 normalization. Subject and methods: This study uses the 2022 Shanghai city closure event as a public health communication case study in the context of COVID-19 normalization, using TikTok as a data source. We first analyze the communication strategies adopted by the PHA based on the Crisis and Emergency Risk Communication (CERC) model. Then, we classify the sentiment of public comments using the Large-Scale Knowledge Enhanced Pre-Training for Language Understanding and Generation (ERNIE) pre-training model. Finally, we explore the connection between PHA communication strategies and public sentiment tendencies. Results: First, the public's sentiment tendencies differ at different stages. Therefore, appropriate communication strategies should be developed stage-by-stage. Second, the public's emotional disposition to different communication strategies varies: government statements, vaccines, and prevention and control programs are more likely to produce a friendly comment environment, while policy and new cases per day are more likely to produce unfavorable comment content. However, this does not mean that policy and new cases per day should be avoided; the judicious use of these two strategies can help PHAs understand the current issues causing public dissatisfaction. Third, videos with celebrity appearances can significantly increase positive public sentiment and, thereby, public participation. Conclusion: We propose an improved CERC guideline for China based on the Shanghai lockdown case.

Community engagement and adherence to COVID-19 prevention measures in Northwest Syria: a systematic review.

The COVID-19 pandemic has increased the burden on the collapsing health system in northwest Syria. The situation was exacerbated by the low rates of adherence to preventive measures and acceptance of the COVID-19 vaccine. In this study, we systematically analysed studies related to Risk Communication and Community Engagement programs, and community awareness in northwest Syria in order to determine the most widespread prevention methods, the community's perspectives and knowledge of epidemic prevention, and the factors that prevent effective community engagement and uptake of COVID-19 prevention precautions in an area that has been suffering from the scourge of conflict for more than ten years. Based on the research findings, low adherence to COVID-19 prevention measures is mainly due to external factors related to socioeconomic status, scarcity of resources, and poor living conditions. Therefore, this study suggested that integrated multi-sectoral humanitarian programs that address these factors holistically are more effective than solely public health interventions in involving the community to become an active part of the Risk Communication and Community Engagement programs and ensuring their effectiveness.

Individualism, economic development, and democracy as determinants of COVID-19 risk information on 132 government websites.

Little is known about how governments transparently communicate about COVID-19. This study conducted a content analysis of 132 government COVID-19 websites to identify the salience of health messages (i.e., perceived threat, perceived efficacy, and perceived resilience) and cross-national determinants of information provision. Multinomial logistic regression was used to estimate the relationship between country-level predictors (i.e., economic development, democracy scores, and individualism index) and information salience. The numbers of deaths, discharged patients, and daily new cases were prevalent on the main webpages. Subpages provided information about vulnerability statistics, government responses, and vaccination rates. Less than 10% of governments included messages that may instill self-efficacy. Democratic countries had higher chances of providing threat statistics on subpages, including daily new cases (Relative Risk Ratio, RRR = 1.66, 95% CI: 1.16-2.37), mortalities (RRR = 1.69, 95% CI: 1.23-2.33), hospitalizations (RRR = 1.63, 95% CI: 1.12-2.37), and positivity rates (RRR = 1.55, 95% CI: 1.07-2.23). On subpages, democratic governments emphasized information about perceived vulnerability (RRR = 2.36, 95% CI: 1.50-3.73), perceived response efficacy (RRR = 1.48, 95% CI: 1.06-2.06), recovery numbers (RRR = 1.84, 95% CI: 1.31-2.60), and vaccinations (RRR = 2.14, 95% CI: 1.39-3.30). Developed countries reported the number of daily new cases, perceived response efficacy, and vaccination rates on their COVID-19 main pages. Individualism scores predicted the salience of vaccination rates on main pages and the omission of information related to perceived severity and perceived vulnerability. Democracy levels were more predictive of reporting information about perceived severity, perceived response efficacy, and perceived resilience on subpages of dedicated websites. Improving public health agencies' communication about COVID-19 is warranted.

Participatory action research to co-design a culturally appropriate COVID-19 risk communication and community engagement strategy in rural Pakistan.

Background: Community engagement has shown to be fundamental component of the response to previous disease outbreaks. This study aimed co-design and implement a culturally appropriate COVID-19 risk communication and community engagement strategy with a resource-poor rural community in Northwest Pakistan. Methods: Participatory Action Research (PAR) was conducted from January 2021 to March 2022. Five PAR meetings took place with community members (n = 30) to: (1) explore how the COVID-19 pandemic impacted on the community; (2) identify challenges to limit the spread of the virus; (3) identify and implement solutions to these challenges; and (4) highlight the enablers, challenges and knowledge of the cultural context needed to optimize safety during emergencies. Focus group discussions (N = 6) with community members not involved in the PAR meetings (N = 50) and children of the community (N = 26) were conducted following the PAR meetings. Thematic analysis of the PAR and focus group data was conducted. Results: Delivery of messages on how to keep families safe, provision of personal protective equipment and improved water systems were part of the strategies taken by the community to create awareness and reduce the spread of COVID-19. Nine themes were identified: Attitudes to the pandemic: From skepticism to acceptance, Changing attitudes about vaccination: rumors and trust, COVID-19 and Faith, Social impact of the pandemic, Access to water, Resource mobilization: personal protective equipment, Spaces where collaborative effort can bring to solutions, Agents of change, and Empowerment of women. Discussion: The participatory approach of this research allowed understanding of the challenges faced by the community to engage in behavior change strategies to reduce the spread of COVID-19 and enabled the community to find sustainable solutions. Engagement with the community empowered men and women to be agents of change and promoted necessary precautionary actions to reduce the risk of infection within their community. Conclusion: Participatory approach highlighted the importance of engaging with and integrating to local culture and values to overcome challenges such as gender imbalance and distrust. Findings of this study are relevant to others working in diverse cultural settings in similar crises events regardless of particular cultural variations.

Psychiatric Boarding in Emergency Departments and the COVID-19 First Wave: The New Hampshire Response.

The COVID-19 pandemic forced unprecedented challenges for emergency department operations during the spring of 2020. Before the COVID-19 pandemic, psychiatric boarding in emergency departments required a substantial amount of staffing and administrative resources. This case study describes one state's efforts to rapidly decrease psychiatric boarding by 93% in 2 weeks with a multipronged approach, and simultaneously minimal effects observed on outcome measures of psychiatric hospital readmissions and suicide rates. Lessons learned are discussed regarding workflow adaptations and leadership implications.