Social media is used by the masses not only to seek health information but also to express feelings on an array of issues, including those related to health. However, there has been little investigation on the influence of expressing and receiving information in terms of health-related engagement on social media. Moreover, little is known of the cognitive mechanisms underlying the expression and reception of health information on information overload (IO) during an infectious disease outbreak. Guided by the Cognitive Mediation Model (CMM), this study proposes a conceptual model to understand the effects of receiving and expressing COVID-19 information on social media on IO. Using an online survey conducted in Malaysia, our results indicated that risk perception positively predicted the reception and expression of information which, in turn, was positively associated with perceived stress and IO. Additionally, perceived stress triggered IO, indicating that the greater the perceived stress from health information engagement, the higher the likelihood of one experiencing IO during the pandemic. We conclude that the CMM can be extended to study IO as an outcome variable. More studies in diverse health contexts need to be conducted to enhance the conceptualization and operationalization of IO in health information processing.

Background The health belief model explains that individual intentions and motivation of health behaviors are mostly subject to external cues to action, such as from interpersonal communications and media consumptions. The concept of mobilizing information (MI) refers to a type of mediated information that could call individuals to carry out particular health actions. Different media channels, especially digital media outlets, play an essential role as a health educator to disseminate cancer health information and persuade and mobilize cancer prevention in the community. However, little is known about calls to action (or MI) in online cancer news, especially from Asian media outlets. Objective This study aimed at analyzing cancer news articles that contain MI and their news components on the selected Malaysian English and Chinese newspapers with online versions. Methods The Star Online and Sin Chew Online were selected for analysis because the two newspaper websites enjoy the highest circulation and readership in the English language and the Chinese language streams, respectively. Two bilingual coders searched the cancer news articles based on sampling keywords and then read and coded each news article accordingly. Five coding variables were conceptualized from previous studies (ie, cancer type, news source, news focus, cancer risk factors, and MI), and a good consistency using Cohen kappa was built between coders. Descriptive analysis was used to examine the frequency and percentage of each coding item; chi-square test (confidence level at 95%) was applied to analyze the differences between two newspaper websites, and the associations between variables and the presence of MI were examined through binary logistic regression. Results Among 841 analyzed news articles, 69.6% (585/841) presented MI. News distributions were unbalanced throughout the year in both English and Chinese newspaper websites; some months occupied peaks (ie, February and October), but cancer issues and MI for cancer prevention received minimal attention in other months. The news articles from The Star Online and Sin Chew Online were significantly different in several news components, such as the MI present rates (χ2=9.25, P=.003), providing different types of MI (interactive MI: χ2=12.08, P=.001), interviewing different news sources (government agency: χ2=12.05, P=.001), concerning different news focus (primary cancer prevention: χ2=10.98, P=.001), and mentioning different cancer risks (lifestyle risks: χ2=7.43, P=.007). Binary logistic regression results reported that online cancer news articles were more likely to provide MI when interviewing nongovernmental organizations, focusing on topics related to primary cancer prevention, and highlighting lifestyle risks (odds ratio [OR] 2.77, 95% CI 1.89-4.05; OR 97.70, 95% CI 46.97-203.24; OR 186.28; 95% CI 44.83-773.96; P=.001, respectively). Conclusions This study provided new understandings regarding MI in cancer news coverage. This could wake and trigger individuals’ preexisting attitudes and intentions on cancer prevention. Thus, health professionals, health journalists, and health campaign designers should concentrate on MI when distributing health information to the community.

BackgroundIn health news production, sourcing and framing are two critical mechanisms that influence how newsreaders think about and perceive the severity of a health issue. Understanding how local media covers the cancer control continuum is vital. However, very limited studies have looked at the effect of sourcing and framing in cancer news coverage, and it is still unknown how sources and news frames shape cancer coverage, especially in non-Western countries.ObjectiveThis study examines framing and sourcing patterns in news stories reporting on cancer control in Malaysian mainstream (English) and ethnicity (Chinese) online news sites, uncovering underlining associations between essential news components, source, and framing.MethodsWe used a predesigned code book to conduct a quantitative content analysis on cancer news stories (n = 841) published on two Malaysian English and Chinese online news sites from 2017 to 2019. Cancer news received adequate coverage in Malaysian English and Chinese media and was also session-centered.ResultsTwo logistic regression models demonstrated the internal relationships between sourcing, framing, and different elements in cancer coverage. In terms of news sources, the results revealed that medical journals were the most likely to be cited when the news focused on medical research, followed by primary cancer prevention. When the news concentrated on statistical cancer reports and environmental/occupational risk factors, government agencies were more likely to be interviewed. Of news frames, when the news articles engaged with medical institutions and mentioned medical publications, the lifestyle frame was very likely to be shown, but the environmental frame was more likely to be portrayed when interviewing medical practitioners.ConclusionThis study is the first comprehensive assessment to analyze and compare Malaysian English and Chinese online cancer news coverages and uncover underlying associations between news components, sourcing, and framing paradigms. We contributed to the scholarly understanding of cancer news coverage. This study can serve as a model for future health promotion researchers, journalists, and policymakers. Implications for cancer risk communication research, health journalist practices, and health policymaking were discussed.

BACKGROUND Cancer is a severe health issue in Malaysia. Different media channels, especially digital media outlets play an essential role as a health educator to disseminate cancer health information, as well as persuade and mobilise cancer prevention in the community. However, little is known about the knowledge of mobilising information (calls to action) in online cancer news, especially from Asian media outlets. OBJECTIVE This study aimed at analysing cancer news articles that contain mobilising information and its news components on the selected Malaysian English and Chinese newspapers with online versions. METHODS The Star Online and Sin Chew Online were selected for analysis because the two newspaper websites enjoy the highest circulation and readership in the English-language and the Chinese-language streams respectively. Two bilingual coders searched the cancer news articles based on sampling keywords, after that read and coded each news article accordingly. Six coding variables were conceptualised from previous studies (i.e., cancer type, news type, news source, news focus, cancer risk factors and mobilising information), and a perfect consistency using Cohen’s Kappa was built between coders (k=.73-.97). Descriptive analysis was used to examine the frequency and percentage of each coding item; Chi-square test was applied to analyse the differences between two newspaper websites, and the associations between examined variables and the presence of mobilising information were examined through binary logistic regression. RESULTS Among 841 analysed news articles, 69.6% (585/841) presented mobilising information. News distributions were unbalanced throughout the year in both English and Chinese newspaper websites; some months occupied the peak (i.e., February and October), but cancer issues and mobilising information for cancer prevention received minimal attention in other months. The news articles from The Star Online and Sin Chew Online were significantly different in several news components, such as the present rates of mobilising information (x^2=9.25, p=.003), providing different types of mobilising information (Interactive MI: x^2=12.08, p=.001), interviewing different news sources (Government Agency: x^2=12.05, p=.001), concerning different news focus (Primary Cancer Prevention: x^2=10.98, p=.001), and mentioning different cancer risks (Lifestyle Risks: x^2=7.43, p=.007). Binary logistic regression results reported that online cancer news articles were more likely to provide mobilising information when interviewed NGOs, focused on topics related to primary cancer prevention, and highlighted lifestyle risks (OR: 2.77, 95% CI: 1.89-4.05; OR: 97.70, 95% CI: 46.97-203.24; OR: 186.28; 95% CI: 44.83-773.96; p=.001; respectively). CONCLUSIONS This study provided new understandings regarding mobilising information in cancer news coverage. It could wake and trigger the individuals’ pre-existing attitudes and intentions on cancer prevention. Thus, health professionals, health journalists, and health campaign designers should be concentrated on mobilising information when distributing health information to the community.

BackgroundThe COVID-19 outbreak is no longer a pure epidemiological concern but a true digital infodemic. Numerous conflicting information and misinformation occupy online platforms and specifically social media. While we have lived in an infodemic environment for more than 2 years, we are more prone to feel overwhelmed by the information and suffer from long-term mental health problems. However, limited research has concentrated on the cause of these threats, particularly in terms of information processing and the context of infodemic.ObjectiveThis study proposed and tested moderated mediation pathways from two types of health information behaviors (social media engagement and interpersonal communication) on information overload and mental health symptoms—long-term stress.MethodsWe conducted a cross-sectional online survey between May and June of 2021 among the Malaysian public. The final sample size was 676 (N = 676). A conceptual model was built to guide the data analysis. We conducted structural equation modeling (SEM), moderation and mediation analyses to examine each direct pathway, moderating and mediating effects.ResultsAccording to the pathway analysis, we found that, during the infodemic period, engaging COVID-19 information on social media positively associated with information overload, but interpersonal communication was negatively related to it. As the proximal outcome, there was also a positive association between information overload and the final outcome, perceived stress. The moderation analysis only reported one significant interaction: risk perception weakened the association between social media engagement and information overload. A conditional indirect effect was demonstrated and the indirect associated between social media engagement and perceived stress mediated through information overload was further moderated by COVID-19 risk perception.ConclusionThis research offers new grounds for understanding health information behaviors and their consequences in the COVID-19 infodemic. We particularly highlighted the distinct functions of health information behaviors in causing information overload, as well as the importance of personal health belief in this process. Our proposed model contributes to the strategies of developing health messaging strategies that may be utilized by public health researchers and health educators in the future.