Variables and tools
The research tools include self-report questionnaires and broadcasted videos described as follows, so that each research group watched a different broadcast and the control group did not watch any broadcast. All questionnaires were programmed by the polling service and approved by the research team before being distributed to the study participants. Prior to the construction of the research questionnaire, an eDelphi process (39) was employed among 30 experts in an attempt to achieve a consensus regarding the risk communication style of each broadcast. Positive and negative affect scale (PANAS) (40–41) was used to classify each broadcast, and then through a series of two rounds, consensus was sought for a minimum threshold of 70%. The findings in this preliminary phase helped validate the research tools.
The following variables were included in the final questionnaire:
Behavioral intention: The questionnaire included five items and was constructed for the present study by adapting statements from previous studies (42). The participants were asked to indicate to what extent they intended to follow the guidelines of the MOH (for example: "In the near future, to what extent do you intend to adhere to wearing a mouth-nose mask when staying in the public space? "), on a Likert scale of 1–5 (1="not at all ", 5="to a very large extent"). This questionnaire was designed to measure the dependent variable "change in behavioral intention", defined as the gap between the average score in the questionnaire at the two measurement points. The participants in the various research groups responded to this questionnaire once after reading the introduction (internal reliability 0.864 according to Cronbach's alpha test) and once more after watching the broadcast (internal reliability 0.887).
Health Belief Model (HBM) model: The questionnaire consisted of seventeen items and was constructed for the current study by adapting the statements from previous studies (42–46) to the topic of the current study (internal reliability 0.872). The participants were asked to indicate their degree of agreement with the items on a Likert scale of 1–5 (1 = "do not agree at all", 5 = "agree to a very large extent"). The questionnaire contained items that referred to the various components of the HBM model: vulnerability (three items, for example: "There is a high chance that I will contract COVID"); severity (three items, for example: "If God forbid I catch COVID, it will be a serious illness, I will need hospitalization or I will have irreversible damage"); benefit (two items, for example: "Following the instructions of the Ministry of Health, helps reduce the spread of the virus"); barriers (four items, for example: "I do not have the patience to follow the instructions of the Ministry of Health"); hints for action (two items, for example: "The information in the media helps me understand how I should behave in order not to get infected with COVID"); and self-efficacy (three items, for example: "I am capable of putting a mask on my mouth and nose wherever I am required to do so according to the instructions"). As is customary in analyses related to the HBM model, in the data analysis, an average score was calculated for each component and a general score for the model, and each component was defined as a confounder. A high score in any component or in the entire model indicates a positive attitude held by the respondent toward the subject.
COVID-19 crisis attitudes: The questionnaire consisted of four items and was constructed for the current study by adapting statements from previous studies to the subject of the current study (36). The participants were asked to indicate their degree of agreement with the items on a scale of 1–5 (1 = "not at all", 5 = "very much"). The questionnaire contained one item that referred to the frequency of following the news on the subject as an intervening variable ("To what extent do you follow the news reports on the outbreak of the coronavirus?") and three items designed to measure the public's level of trust in the authorities during the COVID-19 crisis (e.g., "To what extent do you trust the instructions given by the Ministry of Health to the public during the outbreak of the Corona virus?"). In the data analysis, an average score was calculated for the three questions (internal reliability of the three items related to trust in authorities 0.865). This index evaluated the level of trust in the authorities, where a high score indicates a high level of trust in the authorities during the COVID-19 crisis.
Personality traits: The Big Five questionnaire translated into Hebrew and validated in this language was used (47, 48). The questionnaire is based on self-report, where the participants were asked to indicate their degree of agreement with the description of how they saw themselves on a scale of 1–5 (1="do not agree at all", 5="strongly agree"). The questionnaire contains 44 items and is designed to measure five traits through which it is possible to speculate on a tendency toward patterns of behavior, which were defined as confounders. The score in the questionnaire is calculated according to five subindices: extroversion versus introversion (eight items, for example: "I see myself as having an assertive and decisive personality", original internal reliability 0.80 and in the current study 0.78); neuroticism versus emotional stability (eight items, for example: "I see myself as tense sometimes", original internal reliability 0.81 and in the current study 0.83); agreeableness versus antagonism and hostility (nine items, for example: "I see myself as having a forgiving temperament", original internal reliability 0.68 and in the current study 0.76); conscientiousness versus the lack of conscientiousness (nine items, for example: "I see myself as an employee who performs his/her work well and thoroughly", original internal reliability 0.73 and in the current study 0.76); and openness versus conservatism (ten items, for example: "I see myself as curious about many things", original internal reliability 0.76 and in the current study 0.72). Some of the items were reversed, and an average score was calculated for each subindex, where a high score in each subindex indicates a tendency to have the same trait compared to the other end of the same scale.
Manipulation check: After watching the broadcast, the participants in each group (with the exception of the control group) were asked to rate the feelings that the video evoked in them on four scales, where between the two ends of each scale there were six unnumbered points (for example, "The video evoked a general feeling in me..." with ends composed of the words "positive" and "negative"). A high score indicates the perception of the broadcast as evoking a positive feeling, empowering, calming and motivating to action and therefore as having a positive effect on its viewers.
The intervention in this study was based on video broadcasts issued by official public entities and aired on Israeli media during the first year of the COVID-19 crisis. The following is a brief description of each broadcast used in this study:
Broadcast 1 (group 1): This broadcast was published by the Government Advertising Agency and the MOH and is 53 seconds long. During the broadcast, an Israeli comedian talks to his wife on the phone while shopping in the supermarket. During the broadcast, humorous segments that characterize his performances are interspersed. At some point, the comedian notices that not everyone is wearing a mask. Suddenly, a screeching of violins is heard in the background, a sound that is suitable for a parody of a horror movie. As the music changes to a calm and fun tune, which gives the feeling that everything is fine, he turns to a certain couple and asks the man why he is without a mask, explains to him that it affects everyone personally, shows him how to properly put it on his mouth and nose and ends with a joke.
Broadcast 2 (group 2): This broadcast was published by the Government Advertising Agency and the MOH and is 59 seconds long. The broadcast opens with epic music that evokes a sense of readiness and tension for something big or scary that is about to happen. At the same time, pictures of those recovering from the disease are shown on the screen, and the number of people infected up to that time is shown in red on black. Then, four recovered COVID-19 patients who were in a serious condition talked about the experience they had during hospitalization.
Broadcast 3 (group 3): This broadcast was published by the Civil Defense Authorities and is one minute and 23 seconds long. The broadcast opens with background music that evokes hope, which increases throughout the broadcast until a dramatic climax. On the screen is a rapid sequence of citizens of different age groups and origins, filmed on video against a uniform background, looking at the camera and saying nothing. Later, the first sentence was said: "It is only up to us." The message includes a verbal reference to the importance of an overall mobilization of the public for the purpose of creating a herd vaccination and an acknowledgment of the difficulty that results from changing the routine of life and the new guidelines. Later, the participants referred to the fact that if the public cooperates, acts in a carrying manner, shows good neighborliness and mutual support, we will succeed in overcoming the situation.
Broadcast 4 (group 4): This broadcast was prepared by a private advertising agency for the Israel Medical Association and is 38 seconds long. The broadcast opens with melancholic and slightly dark rapt music that rises to a dramatic climax. First, we see a close-up of the camera on an actor playing a patient sitting on a hospital bed. At the end of the room, busy staff members work in protective suits. The actor says that most of the time he was wearing a mask, and slowly he remembers that in fact he may be wrong, when every time he remembers an event where he was without a mask, the characters on the screen, belonging to the people he met, quickly change. At a certain point, his speech becomes slow, his look sad, and he remembers that even when he visited his mother, he was without a mask. At this point, the members of the medical staff approach him and begin to examine and treat him, and he puts on a mechanical ventilation mask.
Broadcast 5 (group 5): This broadcast was published by the Government Advertising Agency and the MOH and is 51 seconds long. The camera follows a young man in his morning routine with rhythmic and happy music in the background, which accompanies the broadcast until the end. He rushes out of the house, reaches the elevator, and realizes that he is without a mask. The two people standing in the elevator point to their mask as if signaling him to put one on himself. Later, the camera quickly moves between people of different ages and origins without masks holding their foreheads in wonder, then several short clips of hands taking masks of different colors. Starting in the middle of the broadcast, a narrator begins to speak referring to the fact that although it is no longer mandatory to wear a mask in open places, it is important to be mindful of it in gatherings and closed places.