Health Communication

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Introduction to the Special Issue on “Public Health

Communication in an Age of COVID-19”

Xiaoli Nan & Teresa Thompson

To cite this article: Xiaoli Nan & Teresa Thompson (2021) Introduction to the Special Issue on
“Public Health Communication in an Age of COVID-19”, Health Communication, 36:1, 1-5, DOI:
10.1080/10410236.2020.1853330

To link to this article: https://doi.org/10.1080/10410236.2020.1853330

Published online: 09 Dec 2020.

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HEALTH COMMUNICATION
2021, VOL. 36, NO. 1, 1–5
https://doi.org/10.1080/10410236.2020.1853330
Introduction to the Special Issue on “Public Health Communication in an Age of
COVID-19”
a
Xiaoli Nan and Teresa Thompsonb
a
Department of Communication, University of Maryland; bDepartment of Communication, University of Dayton
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 commu­
nication. Given the overwhelming interest in contributing to
the special issue, we decided to publish the invited commen­
taries 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 pre­
dictors 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 commu­
nication. They employed diverse methodologies, including
cross-sectional and longitudinal surveys, controlled experi­
ments, 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 con­
tinents, including China, Israel, New Zealand, South Korea, the
United Kingdom, and the United States.
One of the fundamental goals of public health communica­
tion is to promote risk-reduction behaviors through effective
public health messaging. This special issue opens with four
strong empirical studies that examine the psychological ante­
cedents 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 misin­
formation, Hornik et al., (p. 6) based on a nationally represen­
tative 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
CONTACT Xiaoli Nan nan@umd.edu 1102 Skinner Building, University of Maryland, College Park, MD 20742, USA
© 2020 Taylor & Francis Group, LLC
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 vulnerabil­
ity, 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 beha­
vior adoption. Nazione et al. (p. 23) similarly found that per­
ceived 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 com­
munication 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 differ­
ences between young and older adults in the observed relation­
ships. 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 orga­
nizations. 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 cri­
tical insight into the inner workings of successful EE campaigns
and offered recommendations for implementing future EE pro­
grams 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
2 X. NAN AND T. THOMPSON
are powerful linguistic devices that have the potential of shap­
ing 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 meta­
phor 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 meta­
phors 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 reac­
tance 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 exam­
ined how parents’ perceived knowledge about COVID-19 sig­
nificantly 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) lever­
aged data from the National Cancer Institute’s Cancer
Information Service to examine COVID-19-related inquires
made by cancer survivors, caregivers, tobacco users, and mem­
bers of the general public during the onset and continuation of
the COVID-19 pandemic.
Designing effective public health communication is predi­
cated 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 signifi­
cantly for mental and physical health during the COVID-19
pandemic. They called for future audience segmentation
strategies that explicitly make use of these audience character­
istics. In an ethnographic study of marginalized communities
in New Zealand, Elers et al. (p. 109) revealed that some health
communication interventions might have exacerbated struc­
tural inequalities, leading to further marginalization of disad­
vantaged 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 unin­
tended consequences such as anxiety and government infrin­
gement of citizens’ rights. Other unintended consequences of
problematic communication could include inequities, stigma­
tization, ageism, and delaying medical care. The authors also
cautioned about messages appealing to social values such as
solidarity and personal responsibility, suggesting such mes­
sages 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 com­
mentaries 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 beha­
viors 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 com­
munication, 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
 HEALTH COMMUNICATION 3

work published in it, including this special issue and the pre­ Timothy Curran
viously published special forum on COVID-19 public health Kelly Dailey
communication, where health communication researchers Rene Dailey
come together to meet the challenges of overcoming a global Whitney Darnell
public health emergency. Bryan Denham
Finally, we would like to acknowledge the service of numer­ Amanda Dillard
ous reviewers who helped evaluate the special issue submis­ James Dillard
sions thoroughly and promptly. Without their dedication, this Sharon Dunwoody
special issue would not have come to fruition. Hue Duong
Uttaran Dutta
Reviewers for this special issue: Stine Eckert
Thomas Feeley
Eulàlia Puig Abril Edward Laurence Fink
Bradley Joseph Adame Katherine Foss
Linda Aldoory Diane B. Francis
Agaptus Anaele Fiorenza Gamba
Claudio Baraldi Laura Gavioli
Ambar Basu Anne Gerbensky-Kerbner
Erica Weintraub Austin Christine Gilbert
Young Min Baek Tamar Ginossar
Rachel Bailey Elizabeth Glowacki
Paula Baldwin Linda Godbold
Joshua Ben Barbour Joy Goldsmith
Michael Basil Jeanine Guidry
Erin Basinger Emily Haas
Iccha Basnyat Stephen Haas
Benjamin R. Bates Lauren Hamel
Christopher E. Beaudoin Jee Hee Han
Christina Beck Kyung Jung Han
Mesfin Awoke Bekalu Joy L. Hart
Quinten S. Bernhold Kelly B. Haskard-Zolnierek
John Christopher Besley Rachael Hernandez
Cabral Bigman Cynthia Hoffner
Elisabeth Bigsby Avery Holton
Graham Bodie Yangsun Hong
Porismita Borah Guanxiong Huang
Mary Bresnahan Jisu Huh
Rebecca Katherine Britt Juwon Hwang
Natasha Brown Nicholas T Iannarino
Kenzie A. Cameron Irina A Iles
Heather E. Canary Parul Jain
Joseph Cappella Jacob Jensen
Nick Carcioppolo Emma Jesch
Heather J. Carmack Hepeng Jia
Christopher J. Carpenter Shaohai Jiang
Amy E. Chadwick Xiaoya Jiang
Jiyoung Chae Jessie Quintero Johnson
Chingching Chang Karyn Ogata Jones
LeeAnne Chang Hyoyeun Jun
Li Chen LeeAnn Kahlor
Hyunyi Cho Satveer Kaur-Gill
Myoung-Gi Chon David M. Keating
Sungeun Chung Bridget J. Kelly
Christophere Clarke Shamshad Khan
Marla Clayman Hye Kyung Kim
Kristen L. Cole Jarim Kim
Charles Conrad Seunghyun Kim
Angela Cooke-Jackson Sungsu Kim
Laura Crosswell Andy King
4 X. NAN AND T. THOMPSON

Melinda Krakow Rajiv N. Rimal

Arunima Krishna Yonaira Rivera
Stephen R Lacy Anthony Roberto
Maria Knight Lapinski James D. Robinson
Chul-joo Lee Katherine E. Rowan
Edmund Lee Valerie Rubinsky
Ming-Been Lee Charles Salmon
Seungyung Lee Jennifer Sandoval
Sewo Ting Lee Angeline Sangalang
Stella Juhyun Lee Joshua Santiago
María E. Len-Ríos Melanie A. Sarge
Nehama Lewis Shaunak Sastry
Ruobing Li Emily Scheinfeld
Jiawei Liu Courtney L. Scherr
Miao Liu Peter Schulz
Monique Linette Robinson Luisi Chris Segrin
Brad Love Deborah D. Sellnow-Richmond
Zexin Ma Sayyed Fawad Ali Shah
Erina MacGeorge Fuyuan Shen
Michael Mackert Jingyuan Shi
Jennifer Manganello Weijia Shi
Benjamin Mann Xiaowei Shi
Lesa Hatley Major YoungJu Shin
Lourdes Martinez Aditya Kumar Shukla
Bonnie McConnell Jason T Siegel
Matt McGlone Sandi Smith
Robert McKeever Pradeep Sopory
Bryan McLaughlin Brian Southwell
Margaret McLaughlin Michael Stephenson
Jingbo Meng Laishan Tam
Corine S. Meppelink Naomi Tan
Claude Miller Lu Tang
Ann Neville Miller Kelly Tenzek
Maria Dolores Molina Jagadish Thaker
Rebekah Nagler Charee M. Thompson
Kang Namkoong Esi Eduwaa Thompson
Xiaoli Nan Esther Thorson
Lindsay Neuberger Yan Tian
Minh Hao Nguyen Benedikt Till
Jeff Niederdeppe Scott Titsworth
Seth Noar Daniel Totzkay
Sanghwa Oh Debbie Triese
Yotam Ophir Damian Trilling
Michael P. Pagano Jiun-Yi Tsai
Chong-Hyun Park Jillian A. Tullis
Hee Sun Park Toni van der Meer
Hyojung Park Maria Venetis
Roxanne Parrott Julie Volkman
Sarah Marie Parsloe Emily Vraga
Josh Pederson Kimberly K. Walker
Wei Peng Bryan Whaley
Evan K. Perrault Erin K. Willer
Hans Peter Peters Lillie D. Williamson
Dyah Pitaloka Jessica Fitts Willoughby
Brian Quick Christopher D. Wirz
Stephen Rains Laura Witzling
Rachael A Record Kevin B. Wright
Tobias Reynolds-Tylus Zhan Xu
Sharlene T. Richards Jill Yamasaki
 HEALTH COMMUNICATION 5

Bo Yang Xiaoquan Zhao

Chun Yang Jie Zhuang
Qinghua (Candy) Yang Rick Zimmerman
Sijia Yang Heather Zoller
Itzhak Yanovitsky
Tien Ee Dominic Yeo
Jesse W. C. Yip ORCID
Marco Yzer
Ni Zhang Xiaoli Nan http://orcid.org/0000-0001-8139-0503