INTRODUCTION
The SARS-CoV-2 virus, which first appeared in China’s Wuhan Province in
late December 2019 with various respiratory symptoms, was officially
declared an epidemic by the WHO on March 11, 2020. Although most people
infected can recover without special treatment, anyone can also become
infected with the COVID-19 virus and can become seriously ill or die at
any age.1 The
rapid outbreak and spread of COVID-19 has affected many lives globally,
has placed a heavy burden on health systems, and has caused great
economic losses.2
Given the novelty of the situation, there was no treatment or vaccine
for the disease in the early stages. This led individuals and society to
seek up-to-date information to protect themselves and save
lives.3 When individuals are faced with an uncertain
event, they engage in information-seeking behavior to better cope with
the threat posed by this event (currently COVID-19).4Information behavior is concerned with how people need, seek, manage,
give, and use information in different contexts.5Health information seeking behavior, which means the purposeful
obtaining of health information from selected information carriers, can
provide a variety of benefits, above all the potential to reduce
knowledge gaps between individuals and to educate them. In crises or
disaster situations, information sources can heighten awareness and
consciousness of the current situation, learn about the measures taken,
and reduce anxiety arising from the uncertainty posed by a newly
emerging situation.6 It is critical for individuals to
understand the basic characteristics of the coronavirus, to recognize
the threat of viral disease for their own and for public health, and to
follow appropriate health protocols. Informing the public can reduce
transmission, the spread of the virus, and ultimately lower the burden
on a country’s healthcare facilities. Therefore, especially during the
pandemic, it is very important to be aware of the information the public
is receiving about the coronavirus.7
Both traditional and non-traditional sources of information have been
used to understand the current coronavirus crisis plaguing globally.
This may have been due to widespread curfews, stay-at-home orders in
many countries, travel restrictions, and people’s instinct to better
understand the pandemic because of the uncertainty about the nature of
the disease.8 People were facing a pandemic that they
knew little about and had limited knowledge of before the COVID-19
outbreak. They needed to learn more about the coronavirus to protect
themselves from it. Because they had to exclude themselves from the
social environment, the sources of information were restricted. During
this time, the most effective information sources were television, radio
programs, and the Internet. In the pre-Internet era, the primary sources
of information were traditional media such as television, radio, and
printed publications. Websites have become popular sources of
information since the arrival of the Internet,9 which
provides a wide but variable source of health information and has the
capacity to influence its users.10 Scholars believe
that the new media, especially social media, have great potential to
support information-seeking and decision-making on issues related to
personal care and health.6
The widespread use of social media (YouTube, Instagram, Facebook,
Twitter, etc.), has not only benefits but also has caused
harm.11 Social media have increased knowledge about
the ways of transmission of the virus and the symptoms of COVID-19 and
encouraged their participants to comply with preventive measures, social
distancing, and sanitation. On the other hand, social media is full of
misconceptions, rumors, and misinformation about the disease, which has
caused an increase in fear and anxiety.12 The flood of
conflicting, incorrect, and manipulated information from social media
should be recognized as a global public health
threat.13 Since everyone can express their opinion on
social media platforms, it has become very difficult to distinguish
between true and false information.11 COVID-19 is not
just a pandemic, but also an “infodemic” of complex and dynamic
information–true and false.14 The WHO director
addressed this situation at the 2020 Munich Conference thus:“We’re not just fighting a pandemic, we’re fighting an
infodemic” .15,16 Recent studies have shown how
online forums, social media, online magazines, television, and
newspapers contribute to the spread of information about COVID-19 and in
some cases, misinformation and vaccine hesitancy.17The increase in Internet usage and the reliance on social media such as
YouTube, Facebook, Twitter and TikTok have changed the way society
gathers information.14Napiórkowska-Baran et
al.18 reported that only one in five people learned
about the pandemic from reliable sources. The sources of information
used even influence the decision to vaccinate.
Kim et al.19found that those who used informal sources of COVID-19 information such
as the media, the Internet, and friends or family were more hesitant to
get vaccinated than those who used official sources of information such
as government guidance and health care providers. Distrust in
information sources, especially if there is uncertainty about the
pandemic, can affect adoption of recommended behaviors. Information
overload with rapidly changing, sometimes-questionable content and
sources, can cause confusion, fear, and stress.2Rapidly expanding mass panic over COVID-19 could lead to permanent
psychological problems that could potentially be even more harmful in
the long run than the virus itself. Appropriate use of Internet
services, technology, and social media should be encouraged to curb both
the pandemic and the infodemic.13
The use of social media and the Internet is becoming more common,
especially among young people.20 Experiencing negative
emotions is positively related to the frequency of media use. Young
people exposed to disturbing media images of traumatic events are more
likely to develop post-traumatic stress disorder
later.4 According to
Lin et al.21uncertainty of information was very common among university students
during the pandemic, which was also associated with stress. One of the
groups most affected by the pandemic due to the closure of schools and
various bans has been university students. Therefore, these students
need to be well-protected. In addition, even though
studies8,18,22,23 are focused on the effect of health
information sources on fear of COVID-19, there is no comprehensive study
investigating how fear of COVID-19 shapes the use, preference, and
reliability perceptions of health information sources, in short,
information seeking behavior. To the best of the present researcher’s
knowledge, there is only one study24 that has examined
the effect of fear on the use of online information sources. For that
reason, the present study comprehensively examined how the fear of
COVID-19 affects a large number of information sources (nine of them),
including online information sources (the Internet). Considering the
specified gaps, this study aimed to a) to determine the health
information sources that university students used and trusted the most
during the pandemic, b) to determine the correlations between university
students’ perception of reliability of health information sources and
their use, and c) to determine the effects of fear of COVID-19 on the
perception of the reliability and the use of health information sources
in university students.