JMIR Publications

ABSTRACT

Background:

Risk and crisis communication plays an essential role in public health emergency responses. The COVID-19 pandemic triggers spontaneous and intensive media attention, which affects people’s adoption of personal preventive measures and mental health.

Objective:

This study investigated the associations between exposure to COVID-19 specific information and mental health (depression and sleep quality) and compliance with personal preventive measures (facemask wearing and hand sanitizing); and tested whether such associations were moderated by thoughtful consideration of the veracity of exposed information.

Methods:

A cross-sectional survey was conducted among a sample of factory workers at the beginning of work resumption in Shenzhen, China. A stratified two-stage cluster sampling design was used for recruitment. A total of 3,035 factory workers that had resumed work completed an online self-administered questionnaire. Multivariate linear and logistic regression models were used for analyses.

Results:

The prevalence of probable moderate-to-severe depression and poor/terrible sleep quality was 5.6% (n=170) and 23.9% (n=726), respectively. The prevalence of consistent facemask wearing in any public places and sanitizing hands every time after returning from public spaces or touching installations was 95.7% (n=2,903) and 70.9% (n=2,151), respectively. Around 33.3-54.0% reported a daily exposure to COVID-19 specific information through online media and television for more than one hour. After controlled for significant background variables, higher information exposure via television and newspaper/magazines were associated with better sleep quality (adjusted B=0.06 & 0.07, P<.001) and better compliance with hand sanitizing (adjusted odds ratios [AOR]=1.18 & 1.21, P<.001). Higher exposure via online official media was associated with better compliance with hand sanitizing (AOR=1.08, P=.038) but did not influence mental health. In contrast, higher exposure via online unofficial media was associated with better compliance with hand sanitizing (AOR=1.08, P=.035) but higher depressive symptoms (adjusted B=0.20, P=.001). Lastly, higher exposure through face-to-face communication was associated with higher depressive symptoms (adjusted B=0.46, P<.001), worse sleep quality (adjusted B=-0.04, P=.011), and poorer compliance with hand sanitizing (AOR=0.92, P=.031). Exposure to information about COVID-19 patients’ positive outcomes, development of vaccines/effective treatment and heroic stories about frontline healthcare workers was associated with both better mental health and higher compliance with preventive measures. Higher overall information exposure was associated with higher depressive symptoms among participants who were less likely to carefully consider the veracity of exposed information, while was associated with better sleep quality among those with more thoughtful considerations.

Conclusions:

This study provides empirical evidence on how amount, sources, and contents of information exposure influenced mental health and compliance with personal preventive measures at the initial phase of work resumption in China; and thoughtful consideration of information quality played an important moderating role. Our findings may inform strategic risk communication used by government and public health authorities during the COVID-19 pandemic.