Introduction to the Special Issue on “Public Health Communication in an Age of COVID-19”

In May 2020, we announced the Health Communication special issue Call for Papers (“Public Health Communication in an Age of COVID-19”). The special issue was envisioned to include both invited commentaries and peer-reviewed articles addressing timely topics on COVID-19 public health communication. Given the overwhelming interest in contributing to the special issue, we decided to publish the invited commentaries and peer-reviewed articles in two separate issues. The invited commentaries – 12 of them – have been published as a Special Forum on COVID-19 Public Health Communication in the previous issue. The current Special Issue on COVID-19 Public Health Communication includes exclusively peer-reviewed articles – 13 of them – which were competitively selected from over 150 submissions following rigorous peer reviews.

The 13 peer-reviewed articles featured in this special issue address a wide range of issues central to COVID-19 public health communication, from determining psychological predictors of risk-reduction behaviors, identifying and testing health messaging strategies, examining patterns of COVID-19 information seeking and sharing, understanding marginalized communities disproportionately affected by COVID-19, to scrutinizing ethical implications of COVID-19 public communication. They employed diverse methodologies, including cross-sectional and longitudinal surveys, controlled experiments, qualitative interviews, ethnography, and case studies. Reflecting the global impact of the COVID-19 pandemic, the articles report COVID-19 public health communication research conducted in six different countries across four continents, including China, Israel, New Zealand, South Korea, the United Kingdom, and the United States.

One of the fundamental goals of public health communication is to promote risk-reduction behaviors through effective public health messaging. This special issue opens with four strong empirical studies that examine the psychological antecedents to the adoption of COVID-19 risk-reduction behaviors such as mask wearing and physical distancing. In response to growing concerns about the prevalence of COVID-19 misinformation, Hornik et al., (p. 6) based on a nationally representative two-wave survey of U.S. adults, revealed that beliefs in the benefits of COVID-19 risk-reduction behaviors were better predictors of the adoption of such behaviors than beliefs in COVID-19 misinformation. These findings suggest that health campaigns will be more effective in promoting protective behaviors by emphasizing the benefits of these behaviors, rather than debunking unrelated false claims.

The second article by Kowalski and Black (p. 15) investigates the role of four psychological factors (i.e., perceived vulnerability, perceived severity, perceived response- and self-efficacy) in predicting COVID-19 risk-reduction behaviors. Their findings showed that perceived severity of COVID-19 and perceived effectiveness of risk-reduction behaviors (i.e., perceived response-efficacy) were the most important predictors of behavior adoption. Nazione et al. (p. 23) similarly found that perceived severity and perceived efficacy were significant predictors of COVID-19 prevention behaviors. Collectively, these results highlight the importance of emphasizing the seriousness of COVID-19 and the effectiveness of prevention behaviors such as mask wearing and physical distancing in public health communication aimed at promoting such behaviors.

Crowley et al. (p. 32) sought to understand the role of COVID-19 illness uncertainty and information management in predicting prevention behaviors. Results from a national survey suggest that the adoption of COVID-19 prevention behaviors is positively associated with anxiety induced by uncertainty, cognitive reappraisal (e.g., actively rethinking fears about the virus), and the tendency to directly seek COVID-19 information (as opposed to relying on others as information sources). The findings also indicate notable differences between young and older adults in the observed relationships. Crowley et al.’s research points to the potential utility of public health messages that encourage cognitive reappraisal and direct information seeking.

Designing effective messages to promote risk-reduction behaviors is at the core of public health communication. The next three articles address health messaging strategies for encouraging COVID-19 prevention behaviors. Riley et al. (p. 42) reviewed entertainment education (EE) campaigns in response to health emergencies, focusing on three cases of EE response to the COVID-19 pandemic from leading global organizations. Their analysis suggests that EE built upon engaging story telling is a promising, but often overlooked, approach to COVID-19 public health messaging. The authors provided critical insight into the inner workings of successful EE campaigns and offered recommendations for implementing future EE programs to combat COVID-19 and other health emergencies.

Semino put in the spotlight the use of metaphors in COVID-19 public health communication (p. 50). Metaphors are powerful linguistic devices that have the potential of shaping thoughts, attitudes, and behaviors. Through a comprehensive analysis of the metaphors used in COVID-19 communication, Semino discussed which metaphors should be avoided and which should be adopted. In particular, Semino argued that the “war” metaphor, an extremely common metaphor used in COVID-19 communication, has both strengths and weaknesses; it clearly motivates actions but can also lead to fatalism and attribution of guilt to people who succumb to the disease. Semino recommended using the “fire” metaphor, which evokes vivid imageries and an apt parallel between fire progression and virus spreading. Indeed, strategic use of metaphors opens up many opportunities for COVID-19 public health communication that have eluded research attention.

In an attempt to empirically test the relative effectiveness of different COVID-19 messaging strategies, Ma and Miller (p. 59) conducted an experiment to contrast the effects of messages centered on human agency (e.g., “More people are likely to contract the virus in the coming days.”) versus virus agency (“The virus is likely to prey on more people in the coming days.”). Their findings suggest that messages conveying virus agency could backfire, leading to increased psychological reactance manifested in perceptions of threat, experienced anger, source derogation, and counterarguing. The authors concluded that COVID-19 messages should emphasize human agency, which offers individuals a desirable sense of control, rather than virus agency, in order to achieve the intended effects of the messages.

To communicate with the public effectively about COVID-19, we must also understand where people get COVID-19 information, and why and how they search for and interact with such information. Several articles address these issues, notably during the early phases of the pandemic when there was much uncertainty about the virus. Tang and Zou (p. 74) gave us a rare look at how residents in Wuhan, China, where the COVID-19 pandemic originated, acquired and shared COVID-19 information and how their information need and use changed overtime during different stages of the disease outbreak. Avery and Park (p. 81) investigated parents’ responses to the COVID-19 pandemic and specifically examined how parents’ perceived knowledge about COVID-19 significantly shapes their perceived ability to protect their children (i.e., protective efficacy) and level of information seeking and scrutiny. Finally, Vanderpool et al. (p. 89) leveraged data from the National Cancer Institute’s Cancer Information Service to examine COVID-19-related inquires made by cancer survivors, caregivers, tobacco users, and members of the general public during the onset and continuation of the COVID-19 pandemic.

Designing effective public health communication is predicated on a deep understanding of the audience members the communication seeks to reach and engage. Ihm and Lee (p. 98) argue that traditional demographic factors are insufficient to capture critical audience characteristics shaping pandemic experience. Access to social resources (i.e., social networks) and media resources (i.e., media skills and usage), the authors found in a study of 723 adults in South Korea, matter significantly for mental and physical health during the COVID-19 pandemic. They called for future audience segmentation strategies that explicitly make use of these audience characteristics. In an ethnographic study of marginalized communities in New Zealand, Elers et al. (p. 109) revealed that some health communication interventions might have exacerbated structural inequalities, leading to further marginalization of disadvantaged communities. The authors advocate for a culture-centered approach to COVID-19 public health communication targeting marginalized groups.

Concluding this special issue is Guttman and Lev’s incisive essay calling attention to imperative ethical Issues in COVID-19 communication (p. 116). Specifically, the authors raised concerns about the communication of uncertainty, using threats and scare tactics, and framing the pandemic as a war, arguing these communication practices could lead to unintended consequences such as anxiety and government infringement of citizens’ rights. Other unintended consequences of problematic communication could include inequities, stigmatization, ageism, and delaying medical care. The authors also cautioned about messages appealing to social values such as solidarity and personal responsibility, suggesting such messages could lead to obfuscation of responsibility on the part of government leaders and result in divisiveness due the “free rider” problem. Guttman and Lev’s words warrant serious consideration as COVID-19 public health communication becomes increasingly in demand, with ethical challenges accompanying such communication under-scrutinized.

The 13 special issue articles and the 12 special forum commentaries being published is an exciting moment for the field of health communication, but this moment also arrives at a critical juncture in our nation’s and the world’s COVID-19 pandemic response. When we first announced the Special Issue Call for Papers in May 2020, the United States had 1.1 million cases of COVID-19 and 64,943 deaths associated with the disease. At the time of writing, the total number of COVID-19 cases in the U.S. has exceeded 10 million, with more than 240,000 COVID-related deaths. And the number of daily cases has reached a record high since the onset of this pandemic. Globally, COVID-19 cases and deaths continue to increase at a staggering rate and many countries are experiencing the worst outbreaks since spring 2020. Despite the emergence of encouraging news on vaccine development, prevention behaviors such as physical distancing and mask wearing remain a crucial pandemic response. We need effective, evidence-based COVID-19 public health communication more than ever to encourage and sustain protection behaviors, and to promote public acceptance of future COVID-19 vaccines that are proven safe and effective.

We would like to dedicate this special issue to the late Jennings Bryant. Although most people in the field are well aware of his monumental contributions to the study of communication, few probably know that this journal, Health Communication, was his idea. He pitched it to the publisher, Lawrence Erlbaum Associates (later bought out by Taylor & Francis), and suggested that Teresa Thompson serve as the editor. That was in 1986. Jennings was a brilliant man, a wonderful scholar, and a good human being who served others endlessly. Among his multitudinous contributions to the study of communication, this journal is but one. We know Jennings Bryant would be proud of the journal and the work published in it, including this special issue and the previously published special forum on COVID-19 public health communication, where health communication researchers come together to meet the challenges of overcoming a global public health emergency.

Finally, we would like to acknowledge the service of numerous reviewers who helped evaluate the special issue submissions thoroughly and promptly. Without their dedication, this special issue would not have come to fruition.

Reviewers for this special issue:

Eulàlia Puig Abril

Bradley Joseph Adame

Linda Aldoory

Agaptus Anaele

Claudio Baraldi

Ambar Basu

Erica Weintraub Austin

Young Min Baek

Rachel Bailey

Paula Baldwin

Joshua Ben Barbour

Michael Basil

Erin Basinger

Iccha Basnyat

Benjamin R. Bates

Christopher E. Beaudoin

Christina Beck

Mesfin Awoke Bekalu

Quinten S. Bernhold

John Christopher Besley

Cabral Bigman

Elisabeth Bigsby

Graham Bodie

Porismita Borah

Mary Bresnahan

Rebecca Katherine Britt

Natasha Brown

Kenzie A. Cameron

Heather E. Canary

Joseph Cappella

Nick Carcioppolo

Heather J. Carmack

Christopher J. Carpenter

Amy E. Chadwick

Jiyoung Chae

Chingching Chang

LeeAnne Chang

Li Chen

Hyunyi Cho

Myoung-Gi Chon

Sungeun Chung

Christophere Clarke

Marla Clayman

Kristen L. Cole

Charles Conrad

Angela Cooke-Jackson

Laura Crosswell

Timothy Curran

Kelly Dailey

Rene Dailey

Whitney Darnell

Bryan Denham

Amanda Dillard

James Dillard

Sharon Dunwoody

Hue Duong

Uttaran Dutta

Stine Eckert

Thomas Feeley

Edward Laurence Fink

Katherine Foss

Diane B. Francis

Fiorenza Gamba

Laura Gavioli

Anne Gerbensky-Kerbner

Christine Gilbert

Tamar Ginossar

Elizabeth Glowacki

Linda Godbold

Joy Goldsmith

Jeanine Guidry

Emily Haas

Stephen Haas

Lauren Hamel

Jee Hee Han

Kyung Jung Han

Joy L. Hart

Kelly B. Haskard-Zolnierek

Rachael Hernandez

Cynthia Hoffner

Avery Holton

Yangsun Hong

Guanxiong Huang

Jisu Huh

Juwon Hwang

Nicholas T Iannarino

Irina A Iles

Parul Jain

Jacob Jensen

Emma Jesch

Hepeng Jia

Shaohai Jiang

Xiaoya Jiang

Jessie Quintero Johnson

Karyn Ogata Jones

Hyoyeun Jun

LeeAnn Kahlor

Satveer Kaur-Gill

David M. Keating

Bridget J. Kelly

Shamshad Khan

Hye Kyung Kim

Jarim Kim

Seunghyun Kim

Sungsu Kim

Andy King

Melinda Krakow

Arunima Krishna

Stephen R Lacy

Maria Knight Lapinski

Chul-joo Lee

Edmund Lee

Ming-Been Lee

Seungyung Lee

Sewo Ting Lee

Stella Juhyun Lee

María E. Len-Ríos

Nehama Lewis

Ruobing Li

Jiawei Liu

Miao Liu

Monique Linette Robinson Luisi

Brad Love

Zexin Ma

Erina MacGeorge

Michael Mackert

Jennifer Manganello

Benjamin Mann

Lesa Hatley Major

Lourdes Martinez

Bonnie McConnell

Matt McGlone

Robert McKeever

Bryan McLaughlin

Margaret McLaughlin

Jingbo Meng

Corine S. Meppelink

Claude Miller

Ann Neville Miller

Maria Dolores Molina

Rebekah Nagler

Kang Namkoong

Xiaoli Nan

Lindsay Neuberger

Minh Hao Nguyen

Jeff Niederdeppe

Seth Noar

Sanghwa Oh

Yotam Ophir

Michael P. Pagano

Chong-Hyun Park

Hee Sun Park

Hyojung Park

Roxanne Parrott

Sarah Marie Parsloe

Josh Pederson

Wei Peng

Evan K. Perrault

Hans Peter Peters

Dyah Pitaloka

Brian Quick

Stephen Rains

Rachael A Record

Tobias Reynolds-Tylus

Sharlene T. Richards

Rajiv N. Rimal

Yonaira Rivera

Anthony Roberto

James D. Robinson

Katherine E. Rowan

Valerie Rubinsky

Charles Salmon

Jennifer Sandoval

Angeline Sangalang

Joshua Santiago

Melanie A. Sarge

Shaunak Sastry

Emily Scheinfeld

Courtney L. Scherr

Peter Schulz

Chris Segrin

Deborah D. Sellnow-Richmond

Sayyed Fawad Ali Shah

Fuyuan Shen

Jingyuan Shi

Weijia Shi

Xiaowei Shi

YoungJu Shin

Aditya Kumar Shukla

Jason T Siegel

Sandi Smith

Pradeep Sopory

Brian Southwell

Michael Stephenson

Laishan Tam

Naomi Tan

Lu Tang

Kelly Tenzek

Jagadish Thaker

Charee M. Thompson

Esi Eduwaa Thompson

Esther Thorson

Yan Tian

Benedikt Till

Scott Titsworth

Daniel Totzkay

Debbie Triese

Damian Trilling

Jiun-Yi Tsai

Jillian A. Tullis

Toni van der Meer

Maria Venetis

Julie Volkman

Emily Vraga

Kimberly K. Walker

Bryan Whaley

Erin K. Willer

Lillie D. Williamson

Jessica Fitts Willoughby

Christopher D. Wirz

Laura Witzling

Kevin B. Wright

Zhan Xu

Jill Yamasaki

Bo Yang

Chun Yang

Qinghua (Candy) Yang

Sijia Yang

Itzhak Yanovitsky

Tien Ee Dominic Yeo

Jesse W. C. Yip

Marco Yzer

Ni Zhang

Xiaoquan Zhao

Jie Zhuang

Rick Zimmerman

Heather Zoller