Background: During the COVID-19 pandemic, growth in citizen engagement with social media platforms has enabled public health departments to accelerate and improve health information dissemination, developing transparency and trust between governments and citizens. In light of these benefits, it is imperative to learn the antecedents and underlying mechanisms for this to maintain and enhance engagement. Objective: The aim of this study is to determine the factors and influencing mechanisms related to citizen engagement with the TikTok account of the National Health Commission of China during the COVID-19 pandemic. Methods: Using a web crawler, 355 short videos were collected from the Healthy China account on TikTok (with more than 3 million followers throughout China), covering the period from January 21, 2020, to April 25, 2020. The title and video length, as well as the number of likes, shares, and comments were collected for each video. After classifying them using content analysis, a series of negative binomial regression analyses were completed. Results: Among the 355 videos, 154 (43.4%) related to guidance for clinicians, patients, and ordinary citizens, followed by information concerning the government’s handling of the pandemic (n=100, 28.2%), the latest news about COVID-19 (n=61, 17.2%), and appreciation toward frontline emergency services (n=40, 11.3%). Video length, titles, dialogic loop, and content type all influenced the level of citizen engagement. Specifically, video length was negatively associated with the number of likes (incidence rate ratio [IRR]=0.19, P<.001) and comments (IRR=0.39, P<.001). Title length was positively related to the number of shares (IRR=24.25, P=.01), likes (IRR=8.50, P=.03), and comments (IRR=7.85, P=.02). Dialogic loop negatively predicted the number of shares (IRR=0.56, P=.03). In comparison to appreciative information, information about the government’s handling of the situation (IRR=5.16, P<.001) and guidelines information (IRR=7.31, P<.001) were positively correlated with the number of shares, while the latest news was negatively related to the number of likes received (IRR=0.46, P=.004). More importantly, the relationship between predictors and citizen engagement was moderated by the emotional valence of video titles. Longer videos with positive titles received a higher number of likes (IRR=21.72, P=.04) and comments (IRR=10.14, P=.047). Furthermore, for short videos related to government handling of the pandemic (IRR=14.48, P=.04) and guidance for stakeholders (IRR=7.59, P=.04), positive titles received a greater number of shares. Videos related to the latest news (IRR=66.69, P=.04) received more likes if the video title displayed higher levels of positive emotion. Conclusions: During the COVID-19 pandemic, videos were frequently published on government social media platforms. Video length, title, dialogic loop, and content type significantly influenced the level of citizen engagement. These relationships were moderated by the emotional valence of the video’s title. Our findings have implications for maintaining and enhancing citizen engagement via government social media.

Widespread misinformation about COVID-19 poses a significant threat to citizens long-term health and the combating of the disease. To fight the spread of misinformation, Chinese governments have used official social media accounts to participate in fact-checking activities. This study aims to investigate why citizens share fact-checks about COVID-19 and how to promote this activity. Based on the elaboration likelihood model, we explore the effects of peripheral cues (social media capital, social media strategy, media richness, and source credibility) and central cues (content theme and content importance) on the number of shares of fact-checks posted by official Chinese Government social media accounts. In total, 820 COVID-19 fact-checks from 413 Chinese Government Sina Weibo accounts were obtained and evaluated. Results show that both peripheral and central cues play important roles in the sharing of fact-checks. For peripheral cues, social media capital and media richness significantly promote the number of shares. Compared with the push strategy, both the pull strategy and networking strategy facilitate greater fact-check sharing. Fact-checks posted by Central Government social media accounts receive more shares than local government accounts. For central cues, content importance positively predicts the number of shares. In comparison to fact-checks about the latest COVID-19 news, government actions received fewer shares, while social conditions received more shares.

Background: The global outbreak of COVID-19 has become an international public health crisis. Specific antiviral treatments for COVID-19 are not yet available, and prevention is of particular importance to fight the virus. This study tends to explore and compare the roles of cognitive and affective factors in predicting preventive behavior adoption during the COVID-19 pandemic in China. Methods: An online survey using a quota sampling method to collect responses from 3000 Chinese adults was conducted from March 2, 2020 to March 23, 2020. Questions included sociodemographic features, coronavirus knowledge, negative emotion, risk perception, and behavioral responses. Multiple regression analyses were conducted to examine the predictors of behavioral responses toward COVID-19. Results: On average, respondents had low levels of knowledge about COVID-19 (the overall correct response rate was 7.5%). Most respondents reported moderate to strong negative emotions towards the virus (3.47 out of 5). The average reported perceived chance of infection was 23.89%. For behavioral responses, respondents reported low frequencies of going out for activities (1.98 out of 4) and high frequencies of taking preventive measures (3.22 out of 4). Behavioral responses toward COVID-19 were found to be determined by cognitive and affective variables. Knowledge was negatively related to frequency of going out for activities (β = − 0.11, p < .001). Negative emotion (β = 0.34, p < .001), and risk perception (β = 0.05, p = .007) were positively associated with going out for activities. The explanatory power of affective variables (ΔR² = 12.1%) was greater than cognitive variables (ΔR² = 1.0%). For preventive behaviors, knowledge was positively associated with preventive behaviors (β = 0.22, p < .001). Negative emotion (β = − 0.28, p < .001) and risk perception (β = − 0.05, p = .002) were all negatively associated with preventive measures. Affective variables still showed stronger explanatory power (ΔR² = 8%) than cognitive variables (ΔR² = 4.4%) in predicting preventive behaviors. Conclusions: After the rising period of the COVID-19 outbreak in mainland China, cognitive and affective variables still played important roles in predicting behavioral responses. Compared with cognitive factors, affective factors demonstrated stronger explanatory power in predicting behavioral responses toward COVID-19. The findings may have implications for enhancing individual compliance with guidelines of adopting preventive behaviors in response to COVID-19.