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Title: Grappling with the COVID-19 health crisis : content analysis of communication strategies and their effects on public engagement on social media
Authors: Ngai, CSB 
Singh, RG
Lu, WZ 
Koon, AC
Issue Date: 2020
Source: Journal of medical Internet research, . . 2020, , v. 22, no. 8, e21360, p. 1-16
Abstract: Background: The coronavirus disease (COVID-19) has posed an unprecedented challenge to governments worldwide. Effective government communication of COVID-19 information with the public is of crucial importance.
Objective: We investigate how the most-read state-owned newspaper in China, People's Daily, used an online social networking site, Sina Weibo, to communicate about COVID-19 and whether this could engage the public. The objective of this study is to develop an integrated framework to examine the content, message style, and interactive features of COVID-19-related posts and determine their effects on public engagement in the largest social media network in China.
Methods: Content analysis was employed to scrutinize 608 COVID-19 posts, and coding was performed on three main dimensions: content, message style, and interactive features. The content dimension was coded into six subdimensions: action, new evidence, reassurance, disease prevention, health care services, and uncertainty, and the style dimension was coded into the subdimensions of narrative and nonnarrative. As for interactive features, they were coded into links to external sources, use of hashtags, use of questions to solicit feedback, and use of multimedia. Public engagement was measured in the form of the number of shares, comments, and likes on the People's Daily's Sina Weibo account from January 20, 2020, to March 11, 2020, to reveal the association between different levels of public engagement and communication strategies. A one-way analysis of variance followed by a post-hoc Tukey test and negative binomial regression analysis were employed to generate the results.
Results: We found that although the content frames of action, new evidence, and reassurance delivered in a nonnarrative style were predominant in COVID-19 communication by the government, posts related to new evidence and a nonnarrative style were strong negative predictors of the number of shares. In terms of generating a high number of shares, it was found that disease prevention posts delivered in a narrative style were able to achieve this purpose. Additionally, an interaction effect was found between content and style. The use of a narrative style in disease prevention posts had a significant positive effect on generating comments and likes by the Chinese public, while links to external sources fostered sharing.
Conclusions: These results have implications for governments, health organizations, medical professionals, the media, and researchers on their epidemic communication to engage the public. Selecting suitable communication strategies may foster active liking and sharing of posts on social media, which in turn, might raise the public's awareness of COVID-19 and motivate them to take preventive measures. The sharing of COVID-19 posts is particularly important because this action can reach out to a large audience, potentially helping to contain the spread of the virus.
Keywords: Covid-19
Communication
Public engagement
Social media
Infodemiology
Infodemic
Message style
Health content frames
Interactive features
Framework
Content analysis
Publisher: JMIR Publications, Inc.
Journal: Journal of medical Internet research 
ISSN: 1439-4456
EISSN: 1438-8871
DOI: 10.2196/21360
Rights: ©Cindy Sing Bik Ngai, Rita Gill Singh, Wenze Lu, Alex Chun Koon. Originally published in the Journal of Medical Internet Research (http://www.jmir.org). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
The following publication Ngai CSB, Singh RG, Lu W, Koon AC. Grappling With the COVID-19 Health Crisis: Content Analysis of Communication Strategies and Their Effects on Public Engagement on Social Media J Med Internet Res 2020;22(8):e21360 is available at https://dx.doi.org/10.2196/21360
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