key: cord-0748195-ty3idngi
authors: Buneviciene, Inesa; Bunevicius, Romas; Bagdonas, Sarunas; Bunevicius, Adomas
title: COVID-19 media fatigue: predictors of decreasing interest and avoidance of COVID-19-related news
date: 2021-05-29
journal: Public Health
DOI: 10.1016/j.puhe.2021.05.024
sha: d9e2521927ffa7deb4f90a5b20f460116e1e7ca1
doc_id: 748195
cord_uid: ty3idngi

Objectives COVID-19-related news is important for adherence to public health measures. We examined predictors of interest and avoidance of COVID-19 news in Lithuania. Study design Online survey. Methods An online survey was conducted in between October and December 2020 targeting the general population in Lithuania. Participants rated their interest and avoidance of news about the COVID-19 pandemic, with possible answers ranging from ‘completely agree’ to ‘completely disagree’. Participants were also evaluated for symptoms of depression (Patient Health Questionnaire-8), anxiety (Generalized Anxiety Disorders-7), post-traumatic stress (Impact of Events Scale Revised) and COVID-19 fear (COVID-19 Fears Questionnaires). Results In total, 1036 participants (83% women) completed the survey. Results indicated that 37% of participants were losing interest in COVID-19 news, 32% had started avoiding COVID-19 news and 26% had stopped following news about COVID-19. In the multivariate regression analyses, younger age, greater post-traumatic stress symptoms, less fear of COVID-19 and less frequent use of healthcare professionals for COVID-19 information were independent predictors of decreasing/diminished interest and avoidance of COVID-19 news (all p-values < 0.005). More frequent use of friends/relatives for COVID-19 information was associated with increasing avoidance and diminished interest in news about COVID-19, while more frequent use of internet news portals for COVID-19 information predicted decreasing/diminished interest in news about COVID-19, independently from other factors considered in this study. Conclusions Decreasing/diminished interest and avoidance of news about COVID-19 are common, and are associated with younger age, greater post-traumatic stress symptoms, less fear of COVID-19 and less frequent use of healthcare professionals for COVID-19 information.

The COVID-19 outbreak started in December 2019 in Wuhan, China, and quickly spread worldwide causing a pandemic that has resulted in unprecedented global health, social and economic challenges 1, 2 . The COVID-19 pandemic continues to evolve, effective treatment options remain limited and mortality rate is high in vulnerable populations. It is estimated that the COVID-19 pandemic will remain the major public health threat in the near future 3, 4 .

Social and public health strategies, such as social distancing and wearing masks, are aimed to control the spread of the virus and are recommend even with increasing vaccination rates 5, 6 . Effective communication about the COVID-19 pandemic is important for raising awareness and maximising adherence to social and public health strategies 7 . Indeed, news about the COVID-19 pandemic continues to predominate media agenda worldwide 8 News about the COVID-19 pandemic in traditional and social media outlets are polarised and heavily weighted towards negative stories about the pandemic that elicit negative emotions [10] [11] [12] [13] . For example, a study that examined 41,208 headlines of English news sources between January and June 2020 found that the majority of news headlines evoked negative sentiments 10 . Fear, anticipation, sadness and anger were the main emotions evoked by the news headlines. Constant exposure to threatening topics can increase the risk for adverse physical and mental health problems 14, 15 . Sustained exposure to typically negative news about COVID-19 across media outlets can increase the level of stress and cause desensitisation to COVID-19, which can subsequently result in sub-optimal adherence to social and public health guidelines of the COVID-19 pandemic 16, 17 . Therefore, it is important to identify factors associated with decreasing interest and avoidance of COVID-19-related news in order to optimise communication strategies and adherence to public/social recommendations.

The aim of this study was to examine the incidence and predictors of decreasing interest and avoidance of COVID-19-related news.

An online survey was conducted between 1st October and 20th December 2020. Participants from the general population were invited via e-mail invitations, online forums and social network communities, and also by employing snow-ball sampling. Only participants who were fluent in Lithuanian and aged ≥18 years were invited in the study. Respondents were required to register in the study portal [BLNDED] by entering their mobile phone number, which prompted activation of the study questionnaires. All participants gave informed consent prior to proceeding to an online questionnaire.

The survey took approximately 15 minutes to complete. The study protocol and its consent procedure were approved by the [BLNDED] .

Interest and avoidance of COVID-19 news. Study participants were asked to rate interest ('Losing interest in COVID-19 news' and 'Stopped following news about COVID-19') and avoidance ('Started to avoid news about COVID-19') of news about the COVID-19 pandemic. Participants rated each statement on a five-point Likert-type scale, with possible answers ranging from 'completely agree' to 'completely disagree'. Participants who rated each statement as either agree or strongly agree were considered as losing interest, stopped following or avoided news about COVID-19.

Demographic and health status. Respondents were asked about their gender (male or female), age (18-25 years, 26-40 years, 41-60 years or ≥61 years) and living area (urban or rural). Presence of preexisting medical conditions was assessed using the following question: 'Do you have any pre-existing medical conditions?', with possible answers of 'yes' or 'no'. Self-perceived health status was evaluated by asking 'How is your health in general?', with possible answers 'very good', 'good', 'fair', 'bad' or 'very bad'.

Depressive and anxiety symptoms. Depressive symptom severity was evaluated using the 2-item and 8item Patient Health Questionnaires (PHQ-2 and PHQ-8, respectively) 18 19 . Respondents scoring ≥10 on the PHQ-8 were considered as having moderate-to-severe depressive symptoms 19, 20 . Anxiety symptom severity was evaluated using the 2-item and 7-item Generalized Anxiety Disorder questionnaires (GAD-2 and GAD-7) 2122 . The GAD-7 is widely used for assessment of anxiety symptom severity in the general population with good psychometric properties. Respondents were considered as having anxiety symptoms if they scored ≥10 on the GAD-7 22 .

Post-traumatic stress. Distress caused by traumatic events was evaluated using the Impact of Event scale-revised (IES-R) 23 . The IES-R is a 22-item scale with all items rated from 0 (not at all) to 4 (extremely). IES-R total scores ranged from 0 to 88, with a higher score indicating greater psychological impact. A score of ≥33 has been shown to indicate high probability of diagnosis of post-traumatic stress disorder 24 .

COVID-19 Fear. The COVID-19 Fears Questionnaires for Chronic Medical Conditions (CFQCMC) was used to evaluated fear of COVID-19 25 . The questionnaire evaluates fear of social isolation, treatment of preexisting conditions during the pandemic and risk of COVID-19 complications due to pre-existing conditions. Respondents rate each statement that describes their experience on a typical day in the last week on a 5-point numerical scale ranging from 1 (not at all) to 5 (extremely). CFQCMC total scores ranged from 10 to 50, with a higher score indicating greater fear of COVID-19. 

The majority of study participants were women (83%), living in urban areas (73%) and were aged ≤40 years (63%) [see Table 1 ]. Perceived health status was good or very good of 66% of J o u r n a l P r e -p r o o f respondents and 26% had a pre-existing condition. Thirty-seven percent of respondents reported that they were losing interest in news about the COVID-19, 32% started avoiding news about COVID-19 and 26% stopped following news about COVID-19 (Table 2 ).

In the multivariate regression models (see table 3 One-third of study participants were losing interest and were avoiding news about the COVID-19

pandemic. These findings suggest that COVID-19-related fatigue can result in desensitisation and avoidance of news about the pandemic. According to the World Health Organisation (WHO), pandemic fatigue is defined as "distress which can result in demotivation to follow recommended protective behaviours, emerging gradually over time and affected by a number of emotions, experiences and perceptions" and it is increasingly reported worldwide 26 . Avoidance and denial are commonly used coping strategies at times of stress that help to reduce stress levels in the short-term; however, these defensive strategies can decrease the capacity to effectively handle stressors in the long run 27, 28 .

Avoidance and denial of COVID-19-related information has been associated with reduced compliance to public health measures, which may subsequently contribute to the spread of the disease 5 Our study has several limitations that should be acknowledged. The online survey was subjected to selection bias because the majority of respondents were women and aged ≤40 years. However, we found that increasing age and greater fear of the virus were associated with sustained interest in COVID-19 news, and younger age was implicated as a risk factor for non-adherence to public/social pandemic control measures. Cultural differences, as well as epidemiological and media content variations across countries, should be considered when interpreting our results. Content analysis of news outlets in relation to COVID-19 media fatigue and avoidance should be considered in order to optimise public interest in COVID-19-related news. The large sample size and use of well validated questionnaires are important strengths of our study, thus fortifying reliability of our study findings.

One-third of respondents were losing interest and/or had started avoiding COVID-19 news, and J o u r n a l P r e -p r o o f 

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The study and its consent procedures were approved by the regional ethics committee.

This work was supported by the Research Council of Lithuania under Grant P-COV-20-50.

None declared.J o u r n a l P r e -p r o o f