Abstract
BACKGROUND: Effective communication is essential for promoting preventive behaviors during infectious disease outbreaks like COVID-19. While consistent news can better inform the public about these health behaviors, the public may not adopt them. OBJECTIVE: This study aims to explore the role of different media platforms in shaping public discourse on preventive measures to infectious diseases such as quarantine and vaccination, and how media exposure influences individuals' intentions to adopt these behaviors in the United States. METHODS: This study uses data from 3 selected top national newspapers in the United States, Twitter discussions, and a US nationwide longitudinal panel survey from February 2020 to April 2021. We used the Intermedia Agenda-Setting Theory and the Protective Action Decision Model to develop the theoretical framework. RESULTS: We found a 2-way agenda flow between selected national newspapers and the social media platform Twitter, particularly in controversial topics like vaccination (F(1,426)=16.39; P<.001 for newspapers; F(1,426)=44.46; P<.001 for Twitter). Exposure to media coverage increased individuals' perceived benefits of certain behaviors like vaccination but did not necessarily translate into behavioral adoption. For example, while individuals' media exposure increased perceived benefits of mask-wearing (β=.057; P<.001 for household benefits; β=.049; P<.001 for community benefits), it was not consistently linked to higher intentions to wear masks (β=-.026; P=.04). CONCLUSIONS: This study integrates media flow across platforms with US national panel survey data, offering a comprehensive view of communication dynamics during the early stage of an infectious disease outbreak. The findings caution against a one-size-fits-all approach in communicating different preventive behaviors, especially where individual and community benefits may not always align.