Trends and predictors of COVID-19 information sources and their relationship with knowledge and beliefs related to the pandemic: a nationwide cross-sectional study.

BACKGROUND: The COVID-19 pandemic has led to a heightened need to understand health information seeking behaviors in order to address disparities in knowledge and beliefs about the crisis. OBJECTIVE: This study assessed socio-demographic predictors of the use and trust of different COVID-19 information sources, and the association between information sources, knowledge and beliefs about the pandemic. METHODS: An online survey was conducted among U.S. adults in two rounds within March-April 2020 using social-media advertisement-based recruitment. Participants were asked on their use of eleven different COVID-19 information sources as well as their most trusted source of information. Selection of COVID-related knowledge and belief questions was identified using past empirical literature and salient concerns at the time of survey implementation. RESULTS: The sample consists of 11,242 participants. Traditional media sources (TV, radio or podcasts, or newspapers) when combined were the largest sources of COVID-19 information (91.2%). Among those using mainstream media sources for COVID-19 information (n=7,811, 69.5%), popular outlets included CNN (24.0%), Fox News (19.3%), and other local or national networks (35.2%). The largest individual information source was government websites (87.6%), which was also the most trusted source of information (43.3%); odds of trusting government websites were lower among males (AOR: 0.58, 95% CI:0.53-0.63) and those aged 40-59 and ≥60 years compared to aged 18-38 years (AOR: 0.83, 95% CI:0.74-0.92; AOR: 0.62, 95% CI:0.54-0.71). Participants used an average of 6.1 sources (SD: 2.3). Participants who were male, aged 40-59 or ≥60, not working/unemployed or retired, or Republican were likely to use fewer sources while those with children and with higher educational attainment were likely to use more sources. Participants in April were markedly less likely to use (AORuse 0.41, 95%CI:0.35-0.46) and trust (AORtrust 0.51, 95%CI:0.47-0.56) government sources. The association between information source and COVID-19 knowledge was mixed, while many COVID-19 beliefs were significantly predicted by information source; similar trends were observed with reliance on different types of mainstream media outlets. CONCLUSIONS: COVID-19 information source was significantly determined by participant socio-demographic characteristics and was also associated with both knowledge and beliefs about the pandemic. Study findings can help inform COVID-19 health communication campaigns and highlight the impact of using a variety of different and trusted information sources.