Amid the COVID-19 pandemic, TikTok, an emerging social media platform, has created an information hub to provide users with engaging and authoritative COVID-19 information. This study investigates the video format, type and content of the COVID-19 TikTok videos, and how those video attributes are related to quantitative indicators of user engagement, including numbers of views, likes, comments and shares. A content analysis examined 331 videos from official accounts featured in the COVID-19 information hub. As of 5 May 2020, the videos received 907 930 000 views, 29 640 000 likes, 168 880 comments and 781 862 shares. About one in three videos had subtitles, which were positively related to the number of shares. Almost every video included a hashtag, and a higher number of hashtags was related to more likes. Video types included acting, animated infographic, documentary, news, oral speech, pictorial slideshow and TikTok dance. Dance videos had the most shares. Video themes included anti-stigma/anti-rumor, disease knowledge, encouragement, personal precautions, recognition, societal crisis management and work report. Videos conveying alarm/concern emotions, COVID-19 susceptibility and severity, precaution response efficacy had higher user engagement. Public health agencies should be aware of the opportunity of TikTok in health communication and create audience-centered risk communication to engage and inform community members.

This study examines the impact of message fatigue and what makes people fatigued in the context of the COVID-19 pandemic. Data collected with a Qualtrics panel (N = 744) showed that both active (i.e., reactance) and passive (i.e., inattention) resistance in message processing mediated the relationships between message fatigue and intentions to follow three types of preventive behaviors against COVID-19 (i.e., wearing masks, social distancing, and washing hands). The indirect effect of message fatigue on intention to seek COVID-19 information was explained by inattention but not reactance. Analyses of open-ended responses identified 18 types of COVID-related information that individuals were tired of hearing about. About 73.38% of participants (n = 546) reported that they were tired of hearing about at least one type of information about COVID-19, with mask-wearing being the most frequently mentioned (21.91%). The results extend existing research on message fatigue-evoked resistance to persuasion and provide practical implications for public health message design.

This study focuses on stigma communication about COVID-19 on Twitter in the early stage of the outbreak, given the lack of information and rapid global expansion of new cases during this period. Guided by the model of stigma communication, we examine four types of message content, namely mark, group labeling, responsibility, and peril, that are instrumental in forming stigma beliefs and sharing stigma messages. We also explore whether the presence of misinformation and conspiracy theories in COVID-19-related tweets is associated with the presence of COVID-19 stigma content. A total of 155,353 unique COVID-19-related tweets posted between December 31, 2019, and March 13, 2020, were identified, from which 7000 tweets were randomly selected for manual coding. Results showed that the peril of COVID-19 was mentioned the most often, followed by mark, responsibility, and group labeling content. Tweets with conspiracy theories were more likely to include group labeling and responsibility information, but less likely to mention COVID-19 peril. Public health agencies should be aware of the unintentional stigmatization of COVID-19 in public health messages and the urgency to engage and educate the public about the facts of COVID-19.

The COVID-19 pandemic has seriously impacted the management and trajectory of same-sex relationships. This study considered the mediational role of same-sex partners’ conflict avoidance and the moderating roles of individual and contextual vulnerability factors in the face of the pandemic. Results showed that greater adverse daily life impacts and higher perceived threat of COVID-19 predicted more complaint avoidance, which in turn predicted lower relationship satisfaction and higher anxiety, depression, and substance use. Being a person of color and having higher internalized homophobia exacerbated the pandemic’s negative effects on relationship satisfaction. While moving in with partners during the pandemic was related to more complaint avoidance, lower relational satisfaction, higher relationship termination intentions, and greater mental health risks, it also buffered the negative effects of the pandemic on relational well-being. Same-sex couples are encouraged to constructively solve relational issues and actively discuss moving in decisions. More efforts should be devoted to understanding multiple pandemic-related stressors facing same-sex couples.

Background: As user modification can alter the addictiveness and toxicity of electronic nicotine delivery systems (ENDS), more research is needed to understand the types, motivations, risks, and information sources that lead to these product alterations. YouTube has been identified as a major platform where ENDS users obtain and share information about ENDS products and modifications. However, a comprehensive study of ENDS modification videos on YouTube is lacking. Objective: This study aimed to analyze the content of YouTube videos depicting modifications of ENDS. Methods: YouTube was searched in March 2019 to identify videos depicting ENDS modifications. Search terms were derived from interviews with ENDS users and current literature. We used 28 search phrases that combined the words vape and vaping with modification-related key terms (eg, custom build, modification, and dripping). The final sample included 168 videos. Results: Videos were 1 to 108 min long (median 9.55). Presenters were largely male (117/168, 69.6%), white (94/168, 56.0%), and older than 25 years (94/168, 56.0%). Most videos gave how to instructions (148/168, 88.1%), but few offered warnings (30/168, 17.9%) or mentioned commercial alternatives to modifications they presented (16/168, 9.5%). The ENDS devices most often featured were drippers (63/168, 37.5%) and refillable tanks (37/168, 22.0%). The most often modified ENDS components were coils (82/168, 48.8%) and e-liquids (34/168, 20.2%), which included adding other substances, such as cannabis, to the e-liquids (6/168, 3.6%). Most videos portrayed ENDS modifications positively (106/168, 63.1% positive; 60/168, 35.7% neutral; and 2/168, 1.2% negative) and were either neutral or positive in their overall portrayal of ENDS devices (78/168, 46.4% positive; 89/168, 53.0% neutral; and 1/168, 0.6% negative). Conclusions: This study identified several concerning trends in popular YouTube videos on ENDS modifications, including lack of warnings, the addition of marijuana derivatives to e-liquids, and the positive portrayal of ENDS devices and modifications. By identifying the types of modifications (coil and e-liquid being the most prevalent), this study sets an agenda for research on the effects of modifications.

Background: Cigarette pictorial warning labels (PWLs) could produce stronger quit intentions than text-only warning labels (TWLs) due to greater emotional arousal. Yet, it remains unclear whether PWLs that elicit different levels of emotions produce different outcomes. To better understand the role of negative emotions in the effects of PWLs, this study developed two sets of PWLs arousing different emotional levels (high vs low) but equally high on informativeness and compared them to each other and to the current TWLs.Methods: Adult US smokers (n=1503) were randomised to view nine high-emotion-arousing or low-emotion-arousing PWLs or TWLs. After each label, participants reported the negative emotions they felt while looking at the label. After seeing all the labels, participants reported their intentions to quit smoking. Mediation analyses tested whether message condition influenced quit intentions indirectly through negative emotions.Results: Compared with TWLs, PWLs produced higher levels of negative emotions (b=0.27, SE=0.04, p<0.001). Compared with low-emotion arousing PWLs, high-emotion-arousing PWLs produced higher levels of negative emotions (b=0.24, SE=0.07, p<0.001). Higher negative emotions predicted stronger quit intentions (b=0.20, SE=0.03, p<0.001). Negative emotions mediated the effects of PWLs versus TWLs and high-emotion-arousing versus low- emotion-arousing PWLs on quit intentions.Conclusions: The results provide additional evidence for negative emotions as the mechanism through which PWLs motivate smokers to consider quitting. The findings call on the Food and Drug Administration to design and implement high-emotion-arousing cigarette warning labels.