Contextualized impacts of an infodemic on vaccine hesitancy: The moderating role of socioeconomic and cultural factors.

This study examines how perceived information overload and misinformation affect vaccine hesitancy and how this is moderated by structural and cultural factors. By applying and extending the fundamental cause theory, this study proposes a contextualized impact model to analyze a cross-national survey of 6034 residents in six societies in Asia, Europe and North America in June 2021. The study finds that (1) Older and highly-educated participants were less susceptible to COVID-19 information overload and belief in vaccine misinformation. (2) Perceived information overload led to an increase in vaccine acceptance and uptake, whereas belief in vaccine misinformation caused a decrease. (3) The structural differentiation of vaccine hesitancy was salient and higher socioeconomic status could buffer the negative impact of misinformation on vaccine acceptance. (4) Cultural factors such as collectivism and authoritarian mentality also served as buffers against the misinformation that reduced vaccine acceptance and uptake. These findings add nuanced footnotes to the fundamental causes theory and contribute to the discussion on the global recovery from the infodemic. Besides fact-checking and improving individual information literacy, effective and long-term information management and health policies must pay attention to stratified information gaps across socioeconomic groups, and to contextualize the communication and intervention strategies in different cultures.

Social trust and stress symptoms among older adults during the COVID-19 pandemic: evidence from Asia.

OBJECTIVES: To investigate whether social trust is associated with more stress symptoms among middle-aged and older adults in six East and Southeast Asia regions during the COVID-19 pandemic. METHODS: This multi-region study used cross-sectional survey data collected in May 2020. Participants were a probability-based internet sample of adults aged 55 or older. RESULTS: Government trust was negatively associated with stress in Singapore and South Korea. Higher levels of health care trust were significantly associated with less stress in Singapore and Taiwan. Trust in neighbors was associated with a higher likelihood of stress in Hong Kong and a lower likelihood in Singapore. Social trust was not associated with stress in Japan or Thailand. DISCUSSION: Findings suggest the level of social trust in relation to stress substantially varied by region. Interventions to strengthen trust during COVID-19 and other major health crises need to be tailored to fit regions' unique circumstances.

Pandemic vulnerability, policy feedback and support for immigration: Evidence from Asia.

Past studies have shown that disease threat increases people's hostility towards immigrants. However, in our survey (N = 9571) conducted in five advanced Asian economies during the outbreak of COVID-19, we found that COVID-19 vulnerability was positively associated with support for immigration. Drawing on insight from policy feedback theories, we propose that the positive association is caused by the presence of widespread border crossing restrictions, which have changed the meaning and cost implications of COVID-19. As the outbreak expands, the pandemic has become not just a threat to people's health but also a barrier to globalization. Consequently, people who are worried about the disease may see globalization processes, including migration, as signs of pandemic relief. We find supportive evidence in our analysis. First, the positive association between COVID-19 vulnerability and support for immigration is more salient among respondents who considered restrictions on international travel to be stringent. Second, the positive association between COVID-19 vulnerability and immigration attitude was mediated by perceived economic threat from the pandemic and contribution by immigrants towards the containment of the pandemic. These findings suggest that disease control measures adopted at the global level may alter certain widely accepted effects of disease threat on immigration attitudes.

Stratified Impacts of the Infodemic During the COVID-19 Pandemic: Cross-sectional Survey in 6 Asian Jurisdictions.

BACKGROUND: Although timely and accurate information during the COVID-19 pandemic is essential for containing the disease and reducing mental distress, an infodemic, which refers to an overabundance of information, may trigger unpleasant emotions and reduce compliance. Prior research has shown the negative consequences of an infodemic during the pandemic; however, we know less about which subpopulations are more exposed to the infodemic and are more vulnerable to the adverse psychological and behavioral effects. OBJECTIVE: This study aimed to examine how sociodemographic factors and information-seeking behaviors affect the perceived information overload during the COVID-19 pandemic. We also investigated the effect of perceived information overload on psychological distress and protective behavior and analyzed the socioeconomic differences in the effects. METHODS: The data for this study were obtained from a cross-national survey of residents in 6 jurisdictions in Asia in May 2020. The survey targeted residents aged 18 years or older. A probability-based quota sampling strategy was adopted to ensure that the selected samples matched the population's geographical and demographic characteristics released by the latest available census in each jurisdiction. The final sample included 10,063 respondents. Information overload about COVID-19 was measured by asking the respondents to what extent they feel overwhelmed by news related to COVID-19. The measure of psychological distress was adapted from the Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5). Protective behaviors included personal hygienic behavior and compliance with social distancing measures. RESULTS: Younger respondents and women (b=0.20, 95% CI 0.14 to 0.26) were more likely to perceive information overload. Participants self-perceived as upper or upper-middle class (b=0.19, 95% CI 0.09 to 0.30) and those with full-time jobs (b=0.11, 95% CI 0.04 to 0.17) tended to perceive higher information overload. Respondents who more frequently sought COVID-19 information from newspapers (b=0.12, 95% CI 0.11 to 0.14), television (b=0.07, 95% CI 0.05 to 0.09), and family and friends (b=0.11, 95% CI 0.09 to 0.14) were more likely to feel overwhelmed. In contrast, obtaining COVID-19 information from online news outlets and social media was not associated with perceived information overload. There was a positive relationship between perceived information overload and psychological distress (b=2.18, 95% CI 2.09 to 2.26). Such an association was stronger among urban residents, full-time employees, and those living in privately owned housing. The effect of perceived information overload on protective behavior was not significant. CONCLUSIONS: Our findings revealed that respondents who were younger, were female, had a higher socioeconomic status (SES), and had vulnerable populations in the household were more likely to feel overwhelmed by COVID-19 information. Perceived information overload tended to increase psychological distress, and people with higher SES were more vulnerable to this adverse psychological consequence. Effective policies and interventions should be promoted to target vulnerable populations who are more susceptible to the occurrence and negative psychological influence of perceived information overload.

A tale of two city-states: A comparison of the state-led vs civil society-led responses to COVID-19 in Singapore and Hong Kong.

The East Asian experience in tackling COVID-19 has been highly praised, but this high-level generalisation neglects variation in pandemic response measures adopted across countries as well as the socio-political factors that shaped them. This paper compares the early pandemic response in Singapore and Hong Kong, two Asian city-states of similar sizes, a shared history of SARS, and advanced medical systems. Although both were able to contain the virus, they did so using two very different approaches. Drawing upon data from a cross-national, probability sample Internet survey conducted in May 2020 as well as media and mobility data, we argue that the different approaches were the result of the relative strength of civil society vs. the state at the outset of the outbreak. In protest-ridden Hong Kong, low governmental trust bolstered civil society, which focused on self-mobilisation and community mutual-help. In Singapore, a state-led response model that marginalised civil society brought early success but failed to stem an outbreak among its segregated migrant population. Our findings show that an active civil society is pivotal to effective outbreak response and that trust in government may not have been as important as a factor in these contexts.