key: cord-0061515-k6vkd841 authors: Lee, Yeunjae; Li, Jo‐Yun Queenie title: The role of communication transparency and organizational trust in publics' perceptions, attitudes and social distancing behaviour: A case study of the COVID‐19 outbreak date: 2021-02-07 journal: nan DOI: 10.1111/1468-5973.12354 sha: a354e011cd4dc2fb563f0481d79929816ed8da43 doc_id: 61515 cord_uid: k6vkd841 Integrating social cognitive theory and public relations literature, this study examines the effectiveness of organizations' transparent communication in building public trust and encouraging health‐protection behaviours (i.e. social distancing) during a pandemic, that is, the COVID‐19 outbreak. Three aspects of transparent communication are investigated, namely information substantiality, accountability and participation. Results of an online survey of American citizens show that during the early stage of COVID‐19, information substantiality by state governments and health institutes (e.g., the Centers for Disease Control and Prevention) increases publics' trust, which positively influences their perceived risks, behavioural control and subjective norms. The participation of health institutes, rather than state governments, significantly increases public trust, whereas accountability has no effects. Individuals' perceptions and attitudes towards social distancing predict their social distancing behaviour during the outbreak. Theoretical and practical implications are discussed. The 2020 pandemic caused by the coronavirus (COVID-19) is an unprecedented global crisis. As of April 28, 2020, the number of confirmed COVID-19 cases in the United States reached 1,000,000, with a death toll nearing 60,000 as the number continues to rise (Almasy et al., 2020) . The speed and scale of the outbreak have disrupted American society and economy substantially. To slow the speed of the virus and protect public health, Americans have been asked to practice social distancing (or physical distancing), that is, maintaining distance (approximately six feet) between oneself and other people, outside of their home at all times and to not leave their home except to obtain essential needs, such as medical care or groceries (Pew Research Center, 2020) . Social distancing helps limit contact with infected people and contaminated surfaces; thus, maintaining social distance is one of the best strategies for avoiding exposure to the virus and slowing its spread locally and across the country and the world (Centers for Disease Control and Prevention (CDC), 2020). Anyone can get and spread COVID-19 before knowing that they are sick; hence, government organizations (e.g., the CDC) have continuously emphasized the importance of staying away from others as much as possible despite the absence of symptoms. However, practising social distancing is difficult. Being with others and human connection are fundamental human needs and natural inclinations (DiDonato, 2020) . Social distancing is thus challenging, because it goes against cultural norms of communication and feels impersonal and awkward, as it is not what people have been trained to do with people they like (McArthur, 2020) . Social distancing is especially difficult when it is an abrupt, unexpected and dramatic shift from substantial face-to-face time to very little, which is what people are experiencing during the COVID-19 outbreak (DiDonato, 2020) . However, to slow the spread of the virus and protect individuals, their family, community and the world, practising social distancing is necessary. Given that individuals' intention to follow government instructions is determined largely by the contextual environment (Jung et al., 2013) and public behaviours are affected by government actions during a public health crisis (Reynolds & Quinn, 2008) , communicative efforts by organizations responsible for addressing a crisis and implementing policies (e.g., the government and health institutes) during a pandemic are crucial. An important question is, how can publics be encouraged and persuaded effectively to practice social distancing, which is essential but difficult? Public relations scholars emphasize the importance of strategic communication during a public health crisis for organizations to build quality relationships with publics and influence their behaviours in a way that is desired by the organizations (e.g. Guidry et al., 2017; Yang, 2018) . Particularly, as publics increasingly expect transparency and accountability from organizations (Adams & Evans, 2004) , transparency is regarded as a key element in contemporary strategic communication (Albu & Wehmeier, 2014) to foster public confidence and trust in organizations, such as the government (Fairbanks et al., 2007; Kim, 2018) . The importance of transparency is also emphasized by health/risk communication researchers in increasing trust in institutions (e.g. Freimuth et al., 2014; Quinn et al., 2013; Vaughan & Tinker, 2009 ), which will ultimately change publics' health-related behaviours (e.g. Meredith et al., 2007) . Trust in the government and in the health information it communicates can positively impact publics' health-related outcomes during a pandemic (Quinn et al., 2013) . In the context of a public health crisis, while most public relations studies focus on the effects of communication on publics' issue-related activeness (e.g. Kang et al., 2018; Yang, 2018) , health communication literature provides a thorough explanation of publics' health-related behavioural motivations and outcomes (e.g. Chon & Park, 2019) . However, few studies integrate the literature to examine publics' health-related behaviours during a crisis, which are influenced by the strategic communication efforts of organizations. Thus, by integrating the health communication and public relations perspective, this study aims to examine the effectiveness of transparent communication by the government and health institutes during a public health crisis in increasing public trust and influencing perceptions, attitudes and social distancing behaviour. Furthermore, to understand how organizations' communication efforts influence the complicated nature of publics' behavioural motivations during a crisis, this study draws on social cognitive theory to explain individual health behaviours. Specifically, using the theory of planned behaviour (TPB) and the health belief model, this study attempts to provide an integrative model that can predict publics' social distancing behaviour during the COVID-19 outbreak based on their perceived risks, norms, behavioural control and attitudes towards social distancing. Focusing on the state government and public health institutions (e.g. the CDC) as two major public health crisis-related information sources for publics during the early stage of the COVID-19 pandemic, this study also compares the role of transparent communication in affecting publics' behaviours. Effective communication from the government and public health officials is essential during times of public danger, such as health emergencies, to strengthen publics' resilience (Vardavas et al., 2020) , ensure trust in organizations and facilitate the adoption of behaviours necessary to reduce risks (Quinn et al., 2013) . The literature highlights the importance of communication during a pandemic, particularly in affecting publics' behaviours (e.g. being vaccinated; e.g. Bish et al., 2011; Poland, 2010) . For example, during the H1N1 outbreak, clear communication and trust in government authorities lessened publics' uncertainty about the pandemic, thereby leading to preventive measures (Rubin et al., 2009) . In communicating with publics during a crisis, what matters is not only "what" is communicated (e.g. message content) but also "who" is conveying the information and "how" it is communicated (Larson & Heymann, 2010) . During a pandemic, the "who" is in charge of communication (e.g. the government and health officials) should pay attention to not just "what" is communicated (i.e. communication content) but also "how" it is delivered (Quinn et al., 2013) . Focusing on the COVID-19 pandemic in the United States, this study examines the role of two major organizations that have become focal points in the national public health crisis response, namely health institutions (e.g. the CDC) and the state government. Health institutions, such as the CDC, which is a federal agency under the Department of Health and Human Services, serve as national standards for public health preparedness planning within the United States. Communication from such public health agencies is crucial during a pandemic, because public health officials are often considered as the most truthful spokespersons during such challenging times (Quinn et al., 2013) . Publics also tend to demonstrate high levels of trust in health agencies, such as the CDC (Kowitt et al., 2017) and thus are likely to follow their guidelines, as crucial information sources, during uncertain times. Furthermore, during a public health crisis, though the federal government is often expected to slow the speed of virus entry into the country, state/local governments mainly implement courses of action, including public health interventions (French & Raymond, 2009 ). During the COVID-19 pandemic, as the federal government leads the national response to the outbreak, state and local government officials have taken decisive action (e.g. stay-at-home orders), standing on the front lines to control the spread of COVID-19. Such declarations vary considerably by state (NCSL, 2020) . Therefore, publics' perceptions, attitudes and social distancing behaviour are likely highly affected by government orders in the state where they reside. stantiality. Organizational transparency is typically understood as information disclosure . As a basic human right (i.e. "the right to know"), transparency is often associated with the idea of information completeness or comprehensiveness (Grimmelikhuijsen et al., 2013) . Government transparency, including open administrative procedures and government hearings, is viewed as a key element in democracies (Beaumont, 1999; Finel & Lord, 1999) . In an organizational setting, the importance of openness in the disclosure of information is also emphasized as part of corporate social responsibility (Sykes, 2002) . Second, transparent communication ensures the participation of other parties. The provision or disclosure of information does not constitute transparency (Rawlins, 2008) . To achieve transparency, audiences' capacities for processing information are crucial; thus, audiences should be involved to address the interests of both sides (Heald, 2006) . In other words, the mutual understanding of a message and information is a necessary component of transparent communication (Albu & Wehmeier, 2014) . Therefore, in terms of transparency, organizations are responsible for ensuring that a party who is interested in an organization's actions and decisions can actively participate in acquiring, creating and providing information (Cotterrell, 2000) . Finally, the idea of transparency includes accountability, which refers to the objective and balanced reporting of an organization's activities and policies that hold the organization accountable (Rawlins, 2008) . Accountability also represents organizations' acceptance of responsibility and the alleviation of problems, which is a core strategy for effective crisis communication (Grunig & Hunt, 1984) . Accountability, as a form of democratic decision-making transparency, is relevant in making the decision-making process visible to ascertain publics' understanding and assess outcomes (Grimmelikhuijsen et al., 2013) . Honest and transparent communication is vital in building and maintaining trust-based relationships (Goodman, 2002) . From the perspective of public relations, organizational trust is defined as "one party's level of confidence in and willingness to open oneself to the other party" (Hon & Grunig, 1999, p. 3) . Organizational trust includes three dimensions, that is, integrity (the belief that an organization performs fairly and justly and considers publics' expectations), dependability (the belief that an organization will deliver what it promises) and competence (the belief that an organization can fulfil its promises; Hon & Grunig, 1999) . Trust, as the outcome of effective communication, such as mutuality, transparency and openness, during a crisis, is the primary focus of public relations research (Auger, 2014; Yang et al., 2015; Yang & Lim, 2009 ). In the public health context, trust in government agencies, which reflects individuals' overall evaluation of the performance of political authorities and institutions (Miller & Listhaug, 1990) , has been suggested as a major predictor that advances organizations' agendas, implements policies effectively (Kowitt et al., 2017) and affects relationships between citizens and political entities in general (e.g. Hon & Grunig, 1999) . Most important, trust in the government influences publics' health-related behaviours, such as being vaccinated, during a pandemic (Poland, 2010; Quinn et al., 2013) . Trust in health institutions also fosters publics' health-related behaviours (Meredith et al., 2007) . For these reasons, the growing body of literature suggests that organizations (i.e. the government and health institutions) should incorporate strategic communication efforts with considerable transparency to increase publics' level of trust (Huang, 2004) . Transparency is an important tool for organizations to demonstrate trustworthiness and manage organizational reputation (Goodman, 2002) . Specifically, information availability (Fombrun & Rindova, 2000) and accountability (Vaughan & Tinker, 2009 ) breed trust. In an organizational setting, scholars also empirically demonstrated that transparent communication influences internal publics' trust level (Lee & Li, 2019) . Open, responsive and transparent communication have been suggested as key elements in fostering public trust in the government (Fairbanks et al., 2007; Kim, 2018) , which indicates democratic governance (Grimmelikhuijsen et al., 2013) by creating a culture of openness and increasing the confidence of citizens in the government's abilities (Beaumont, 1999) . The role of technology (e.g. social media) was particularly emphasized to increase publics' trust level (Appleby-Arnold et al., 2019) . The close link between communication and trust during a pandemic is also well-demonstrated (Freimuth et al., 2014; Shore, 2003) . During the H1N1 pandemic, officials' openness about evolving information increased publics' perceived quality of communication and trust in government actions (Quinn et al., 2013) . According to Kang et al. (2018) , in the MERS context, mutuality and openness, which are similar to the key attributes of government transparent communication, can reduce the level of public distrust against the government. Communication transparency from public health officials during a pandemic also plays an important role in increasing public trust (Vaughan & Tinker, 2009 ). Therefore, this study expects that transparent communication, information substantiality, accountability and participation will increase public trust in an organization, thereby leading us to propose the following hypotheses: H 1 Transparent organizational communication, namely (a) information substantiality, (b) accountability and (c) participation, during a pandemic, will increase public trust in an organization. Organizational trust during a pandemic is key (Funk, 2020) in encouraging publics to comply with recommended preventive measures, such as social distancing. To understand the motivational routes of individuals for engaging in social distancing behaviour during the COVID-19 pandemic based on their trust in organizations, this study draws on a social cognitive framework, which identifies key factors that predict individuals' decision-making process. Such key factors include trust in the government, risk perception of the pandemic, attitudes, subjective norms and perceived behavioural control over the acceptance of preventive measures (e.g. Leppin & Aro, 2009; Prati et al., 2011) . Social cognitive theory offers essential premises for linking these variables to behavioural intention and actual behaviours (Bandura, 1986) . Moreover, the impact of these variables can be explained by several health behavioural change models, such as TPB and the health belief model. These models indicate that cognitive and social factors are the central determinants of recommended-behaviour adoption (Fishbein & Ajzen, 1980; Rosenstock, 1974) . According to these models, in the case of a pandemic, risk perceptions refer to perceived vulnerability and severity judgment of a pandemic (Ibuka et al., 2010) . Meanwhile, attitude is defined as one's belief about whether engaging in precautionary actions can generate positive outcomes. Finally, subjective norms refer to one's perception of whether his/her important referents agree with practising precautionary actions. The social acceptability and endorsement of behaviour play an important role in a person's decision-making process (Ajzen, 1991) . Perceived behavioural control is defined as one's perception of the ease of performing precautionary actions. The health behaviour model postulates that individuals systematically process available information and carefully consider the outcomes of their actions (e.g. social distancing) based on these perception variables. Given that organizational trust plays an important role in shaping publics' perceptions of and attitudes towards a pandemic and related preventive guidelines (Poland, 2010; Quinn et al., 2013) , this study hypothesizes trust as a precursor of individual social cognitive variables. Thus, the specific links between organizational trust and social cognitive factors are discussed in the following sections. In pandemic management, organizational trust (e.g. government trust) has been shown to broaden individuals' health knowledge about a pandemic and increase their awareness of risk situations (Quinn et al., 2013) . The trust and confidence model suggests that trust in the government plays an important role in pandemic management, as it influences individuals' evaluation of risks and thus can indirectly affect the acceptance of preventive measures (Siegrist et al., 2003) . However, a lack of trust in the government generates scepticism regarding public health warnings (Vaughan & Tinker, 2009 ). Such doubt may influence publics to underestimate the vulnerability and severity of a disease (Blair et al., 2017) . Similarly, institutional trust serves as the foundation of how pandemic outbreak communication is heard, interpreted and responded to and can reinforce perceived threats of a disease (Slovic, 2000) . Thus, we expect that trust in organizations during the COVID-19 pandemic, including the state government and health institutions, positively influences publics' risk perceptions of a pandemic. The following hypothesis is thus proposed: H 2 Publics' trust in an organization will increase their perceived risks of a pandemic. Given the high uncertainty and extreme impact of a pandemic, the pandemic and risk communication literature suggest that trust in the government is an essential element of public cooperation towards government action (Houston & Harding, 2013) . Institutional trust has been identified as one of the most important variables for predicting publics' attitudes and preferences towards preventive measures in pandemic management (SteelFisher et al., 2010; Taylor-Clark et al., 2005) . Public health research indicates that trust in the government enhances individuals' confidence in institutions, thereby increasing perceived legitimacy of government action as well as the expected outcomes of such action (Vaughan et al., 2012) . The trusting relationship between an institution and its publics enables positive expectations that negative outcomes will not occur if the publics comply with institutional guidelines (Pavlou & Fygenson, 2006) . In addition, such a relationship creates an impression that an institution will prioritize its publics' interests (Hosmer, 1995) . These optimistic expectations that build on trust create positive perceptions of the outcomes of institutional actions, thereby generating positive attitudes towards related policies (Pavlou, 2003) . Thus, we expect that trust in organizations (i.e. health institutions and the government) may influence publics' attitudes towards pandemic preventive measures, which is social distancing in this study. Thus, we propose the following hypothesis: H 3 Publics' trust in an organization will influence their attitudes towards social distancing. Most research that integrates institutional trust and normative beliefs examine the two variables separately with no interactions (e.g. Hsieh, 2015) . However, research on social capital suggests that trusting relationships with the government may establish social capital, which is a social norm that can "facilitate coordination and cooperation for mutual benefit" (Putnam, 1995) . Trust in government reputation, image and actions can thus establish a mutual and healthy relationship between institutions and publics, thereby creating a social norm of government action acceptance (Chuang et al., 2015) . Specifically, scholars indicated that individuals' perceptions of the reference groups' behaviours or interpersonal agreements can be determined by subjective culture variables, the approaches people use to interpret the social environment (Triandis, 1980) . In an organizational context, essential elements of organizational trust, such as fairness and integrity, reflect the perceptions of subjective culture variables; these perceptions will then affect the formation of social pressure or subjective norms (Ellis & Shockley-Zalabak, 2001; Fu & Lee, 2005) . Namely, higher levels of organizational trust can reflect publics' positive values of being treated with fairness and integrity by the organization. These perceptions decrease the likelihood that people attempt to behave differently or increase the likelihood that people comply with others in the social environment (Fu & Lee, 2005) , as such trusting relationships leads to less rupturing behaviour among publics (Chang, 2007) . Particularly in the pandemic context, organizational trust can help facilitate effective interaction and communication between the government and the publics and thus allow greater health information flow (Jung et al., 2013) , which serves as an important resource that mobilizes a community and establishes social pressure regarding the precautionary measure adoption (Lee & Kam, 2015) . Based on this line of reasoning, in the context of this study, organizational trust is expected to enhance the public's perceived social pressure to practice social distancing behaviour (i.e. subjective norms). The following hypothesis is thus posed: H 4 Publics' trust in an organization will increase their perceived norms regarding social distancing. Trust in an institution can be a resource to help publics cope with social uncertainty and unexpected contingencies (Gefen, 2002) , thereby resulting in considerable control over certain behaviours (Pavlou & Fygenson, 2006) . Moreover, trust in an institution can indicate support for its actions, which may motivate individuals to overcome barriers to engage in a behaviour or cooperate as an expression of support (Hsu et al., 2007) . Thus, the positive impact of organizational trust on publics' perceived behavioural control during the COVID-19 pandemic is expected, and the following hypothesis is proposed: H 5 Publics' trust in an organization will increase their perceived behavioural control over social distancing. In addition to considering all social cognitive factors as parallel variables that can predict behavioural intentions, this study investigates the role of subjective norms in shaping one's risk perceptions, attitudes and perceived behavioural control over a behaviour. Although the majority of research on TPB considers the three main variables, namely attitudes, subjective norms and perceived behavioural control, as exogenous factors that lead to behavioural intentions, scholars suggest that subjective norms may exert an impact on attitudes and perceived behavioural control (Quintal et al., 2010) . According to TPB, one's attitudes and perceived control towards a behaviour are both considered to be personal factors because such attitudinal perceptions are internally generated on the basis of the person's evaluations of the potential outcomes or competence to complete the behaviour. In contrast, one's subjective norms are viewed as a social factor as they depend on people who surround the person and one's perceived social pressure to perform the behaviour (Bandura, 1986) . Scholars argued that an individual's attitudes or perceived behavioural control can be contingent on his/her perceived subjective norms (Oliver & Bearden, 1985; Park, 2000) . Norm beliefs about a behaviour in the social environment serve as facilitators or barriers in individuals' decision-making processes (Bagozzi et al., 2004; Han et al., 2010) . The literature in social psychology has also long acknowledged that the attributes of the social environment and social pressure play critical roles in shaping one's attitudes (Eagly & Chaiken, 1993) . Accordingly, individuals' perceptions of others' expectations or/and behaviours are found to directly influence the formation of attitudes and behaviour control perceptions because subjective norms are outcomes of social normative pressures (Park, 2000) . Moreover, social norms are constructed within informal personal networks, which facilitates the delivery of risk information (Kasperson et al., 1988) . According to the social amplification of risk framework, the diffusion power of information delivered within a social network could influence the magnitude of risk perception of a specific issue (Kasperson et al., 1988; Renn, 2011) . Although earlier studies of TPB placed subjective norms as an exogenous construct leading to intentions and behaviour, many studies have attempted to identify the causal relationship between subjective norms and other variables (e.g. Al-Swidi et al., 2014) . While it might be argued that perceptions that are internally created such as risk or attitudes can influence normative beliefs, scholars suggested that it is more likely characteristics of the social environment will affect characteristics of the person (Eagly & Chaiken, 1993; Ryan, 1982) . This is particularly relevant in this study's context. The novelty and ambiguity of COVID-19 have resulted in larger-scale uncertainty in society compared with other pandemics in the past (Altschuler, 2020) . In uncertain situations, such as the present, in which effective preventive measures are unclear, individuals may likely use others' behaviours as evidence or justification to decide to also adopt the same behaviour (Cialdini et al., 2006; Kim et al., 2015) . Thus, we expect the impacts of norms on social cognitive variables, proposing the following hypotheses: H 6 Publics' perceived norms will increase their (a) perceived risks of a pandemic, (b) positive attitudes and (c) perceived behavioural control over social distancing. In the social cognitive approach, the primary models of health behavioural change, such as the health belief model, TPB and protection motivation theory, identify factors that can predict the outcome variables of behavioural intention and actual behaviours (Schwarzer, 2001) . These theoretical frameworks share several common factors, such as risk perceptions, attitudes, social norms and perceived behavioural control. Based on previous studies on health communication, this study assumes that such factors can predict publics' adoption of social distancing during the pandemic. Thus, the following hypotheses are proposed. The conceptual model is presented in Figure 1 . An online survey was conducted with participants in the United States for 1 week in early April 2020 after the social distancing guideline for COVID-19 was presented by the CDC on April 4 (CDC, 2020) and the stay-at-home order was implemented in all 50 states (Mervosh et al., 2020) . Participants were recruited through Amazon Mechanical Turk (MTurk). The Mturk user population represents the demographic distribution in the United States (e.g. Casler et al., 2013; Mason & Suri, 2012) and tends to be more diverse than the population drawn from traditional survey research (Buhrmester et al., 2016) . Therefore, Mturk samples for social scientific research is an appropriate participant recruitment pool for numerous studies, including communications research (e.g. Krishna, 2018) . To obtain a nationally representative sample of the US population in terms of age, gender and race/ethnicity, stratified random sampling was used. The participants were compensated for $1 for participating in the 15-min survey. After removing invalid responses (e.g. who are not qualified for the survey, who spent less than 4 min or more than 1.5 hr in a survey, who failed attention check questions), among the initial 823 survey participants, this study retained a final sample of 502. Of the final sample of 502 participants (mean age = 36.6, SD = 11.4), 50% of them were male (n = 251). A majority of them were Caucasian (n = 365, 73%) and held bachelor's or postgraduate degrees (n = 408, 81.3%). 75.4% of the participants (n = 378) had more than $40,000 of household income, and 77.1% of them (n = 387) were currently employed full-time. In terms of political affiliation, 43.8% of the respondents (n = 220) identified themselves as liberal, while 32.7% (n = 164) of them were conservative Table 1 summarizes the demographic information of these participants. All measurement items were adopted from previous literature. A 5point Likert scale from strongly disagree (=1) to strongly agree (=5) was used for the items. For transparent communication and organizational trust, participants were asked to answer each item twice for two organizations, health institutions (e.g. CDC) and state government, respectively. To measure individuals' perceived behavioural control, five items (α = 0.735) were used from Cho and Lee (2015) and Krishna (2018) . Individuals' attitudes towards social distancing were measured with six revised items (α = 0.923) adapted from Krishna (2018) . In terms of social distancing behaviour, three items (α = 0.749) were used. A list of measurement items is presented in Table 2 . Table 3 reports descriptive statistics and correlations among the variables. During the time when the data were collected, participants as a whole, in general, were highly engaged in social distancing behaviour (M = 4.21), while their positive attitude towards social distancing was moderate (M = 3.36). Participants also had a moderately high level of perceived risk, norm and behavioural control (Ms > 3.8). In terms of perceived transparent communication efforts by two organizations and trust level, publics are more likely to trust health institutes (M = 3.82) than state government (M = 3.57), t(501) = 6.79, p < .001. Moreover, publics tend to believe that compared to the state government, health institutes provide more substantial information about the outbreak (t(501) = 6.19, p < .001) and be more accountable for the crisis (t(501) = 3.40, p = .001). No significant difference was found for participation between the two organizations (t(501) = 0.672, p = .502). A series of t tests, ANOVA and regression analysis was conducted to examine the effects of demographic variables on the main The CFA results showed that the measurement models fit the H6 examined how publics' norm increases perceived risks, attitude and perceived behavioural control, respectively. Norm was significantly and positively related to perceived risks in both mod- An increasing number of studies discuss the effective crisis/risk communication strategies during the COVID-19 in diverse settings (e.g. -Ginsberg & Petrun Sayers, 2020; Petridou & Zahariadis, 2021; Subert, 2020 for providing substantial information that is truthful, timely and relevant to satisfy publics' needs. As noted by numerous public relations and crisis communication studies, releasing information is crucial for building public trust during a crisis (e.g. Chang, 2020; Huang, 2004) , which was also demonstrated empirically in the current study. Moreover, participation, which is similar to the concept of listening and mutuality, has been considered as a normative and ethical communication model in the literature (e.g. Kang et al., 2018) . Our results indicated that the idea of participation, as a core element of transparency, was effective in establishing public trust in health institutions during a public health crisis. However, state governments' participative efforts were not significantly related to publics' level of trust. The risk communication literature suggests that publics will trust the government when the government sends empathetic and caring messages and demonstrates competence and expertise in their promises and actions (Reynolds & Quinn, 2008) . The literature likewise posits that publics may expect reassurance and directional leadership from the government during a pandemic to feel relieved and take immediate specific steps to avoid health risks rather than speaking up on an issue to the government. In other words, not all publics may want to participate in the decisionmaking process. Some may want to merely follow directions provided by authorities during an uncertain period. In addition, public participation occasionally delays organizations' decision-making process (Godschalk et al., 2003) , thereby preventing organizations from providing information quickly and timely. Therefore, whether or not publics perceived opportunities to express their opinions or for the state government to listen to them did not necessarily increase trust during a pandemic. Results of the hypothesized model Furthermore, accountability was not a key element for enhancing publics' trust during a pandemic. Generally, though the notion of accountability based on reporting balanced information, that is, positive and negative information, and admitting mistakes helps organizations establish quality relationships with publics, our findings suggested that this situation was not always the case during a pandemic. One possible explanation was that publics may not consider these organizations responsible for the pandemic, unlike other types of organizational crises. When publics perceive a pandemic as uncontrollable and view government organizations and health institutes as victims (Coombs, 2007) , they will not necessarily expect these organizations to acknowledge their mistakes, which is not related to how much they trust these organizations to address the crisis. (Cho & Lee, 2015) . However, our findings highlighted the significant predictive power of social factors in terms of social distancing behaviour. As we noted above, such a pattern may be explained by the novel and uncertain situations created by COVID-19 in the United States. The ambiguity and uncertainty of the crisis situation may encourage publics to use other people as references to decide whether or not to follow the same behaviour (e.g. Kim et al., 2015) . Moreover, in addition to the direct impact of subjective norms on behaviours, our findings showed that individuals' cognitive behaviours (i.e. perceived risks, attitudes and perceived behavioural control) also depended on how their important referents, such as family and friends, viewed the adoption of social distancing (see Table 4 for the results of direct (Davis et al., 2015) . Therefore, such individual-first thinking may discredit preventive measures that prioritize community benefits but constrain individual freedom (Davis et al., 2015) . As shown in Table 4 , however, it was found that normative beliefs acted as a significant mediator that increased the effect of organizational trust on publics' agreement towards social The current study also provided important practical implications for managing a pandemic through strategic communication. Organizations' transparency is expected more than ever through direct inputs on issues that affect publics. Based on the tested model, organizations responsible for public health crises (i.e. the state government and health institutes) should provide relevant, accurate and timely information to help publics (re)build trust, which can enhance individuals' perceived risks and community norms and ultimately lead to desired behaviours, such as social distancing in this case. Health institutions, such as the CDC, should also provide opportunities for publics to participate in obtaining and creating information related to the crisis. This situation would create the impression that organizations prioritize publics' interests, which will encourage them to build trust and develop positive perceptions of the guidelines or actions of an institution. Meanwhile, state governments need to consult with public health and crisis communication experts and collaborate closely with health institutions to identify situations accurately, which will help them communicate the benefits of social distancing to publics clearly and effectively. Moreover, promotion programmes may consider perceived risks, attitudes, norms and perceived behavioural control related to social distancing. Given that social norms were the strongest predictors in this study, generating positive social pressure for individuals to follow social distancing instructions will likely be considerably effective in enhancing their recommended cognitive behaviour, thereby increasing the likelihood of practising social distancing. Thus, proposing programmes and messages that can help establish general prosocial distancing norms is essential. This study has several limitations that should be addressed. First, this study was based on cross-sectional survey data collected in early April during the early stage of the stay-at-home order and lockdown. After the implementation of state-led orders, public opinions on social distancing changed and became polarized with the occurrence of anti-social distancing rallies across the nation (Corse & Calvert, 2020) . In addition, the data were collected during the early stage of COVID-19, which limited our choice of organizations (e.g. health institutes, local government) in this study. For example, although the CDC generally holds a communication leadership role in public health emergencies, its credibility may have been diminished as a result of its acquiescence to the administration's demands (Sun & Achenbach, 2020) . A longitudinal design is thus needed for future studies to understand the dynamics of public responses to government communication and social distancing. Second, publics tend to use presidential communications as a crucial information source (Brenan, 2020) . The significant impact of the word of the president, the White House, and the federal government was not examined in this study. Thus, future studies should investigate how transparent communication from Andrey, 2019; Zhao et al., 2019) could also be examined as mediating or moderating factors in future studies. The author declares that there is no conflict of interest. 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Health Communication The influence of self-efficacy, subjective norms, and risk perception on behavioral intentions related to the H1N1 flu pandemic: A comparison between Korea and the US Predicting public support for government actions in a public health crisis: Testing fear, organization-public relationship, and behavioral intention in the framework of the situational theory of problem solving Social capital and health-protective behavior intentions in an influenza pandemic Extending the theory of normative social behavior to predict hand-washing among Koreans Managing social norms for persuasive impact Communication missteps during COVID-19 hurt those already most at risk Protecting organization reputations during a crisis: The development and application of situational crisis communication theory Fed up with staying home, some Americans push back Transparency, mass media, ideology and community Beyond resistance: Social factors in the general public response to pandemic influenza The hard work of social distancing The psychology of attitudes Trust in top management and immediate supervisor: The relationship to satisfaction, perceived organizational effectiveness, and information receiving Transparency in government communication The surprising logic of transparency Understanding attitudes and predicting social behavior The road to transparency: Reputation management at Royal Dutch/Shell. The Expressive Organization Trust during the early stages of the 2009 H1N1 pandemic Pandemic influenza planning: An extraordinary ethical dilemma for local government officials IT based knowledge sharing and organizational trust: The development and initial test of a comprehensive model Polling shows signs of public trust in institutions amid the pandemic Reflections on the dimensions of trust and trustworthiness among online consumers Public participation in natural hazard mitigation policy formation: Challenges for comprehensive planning Guest editorial The effect of transparency on trust in government: A cross-national comparative experiment Managing public relations Ebola on Instagram and Twitter: How health organizations address the health crisis in their social media engagement Application of the theory of planned behavior to green hotel choice: Testing the effect of environmental friendly activities Varieties of transparency Guidelines for measuring relationships in public relations. Institute for Public Relations Trust: The connecting link between organizational theory and philosophical ethics Public trust in government administrators: Explaining citizen perceptions of trustworthiness and competence Physicians' acceptance of electronic medical records exchange: An extension of the decomposed TPB model with institutional trust and perceived risk Knowledge sharing behavior in virtual communities: The relationship between trust, self-efficacy, and outcome expectations Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives The SARS epidemic and its aftermath in China: A political perspective. National Academic of Science The dynamics of risk perceptions and precautionary behavior in response to 2009 (H1N1) pandemic influenza The effects of repetitive information communication through multiple channels on prevention behavior during the 2015 MERS outbreak in South Korea Associations between health communication behaviors, neighborhood social capital, vaccine knowledge, and parents' H1N1 vaccination of their children From concerned citizens to activists: A case study of 2015 South Korean MERS outbreak and the role of dialogic government communication and citizens' emotions on public activism The social amplification of risk: A conceptual framework Scientific uncertainty as a moderator of the relationship between descriptive norm and intentions to engage in cancer risk-reducing behaviors Enhancing employee communication behaviors for sensemaking and sensegiving in crisis situations Awareness and trust of the FDA and CDC: Results from a national sample of US adults and adolescents Poison or prevention? Understanding the linkages between vaccine-negative individuals' knowledge deficiency, motivations, and active communication behaviors Public health response to influenza A (H1N1) as an opportunity to build public trust Why does social capital matter in health communication campaigns? The value of internal communication in enhancing employees' health information disclosure intentions in the workplace Risk perceptions related to SARS and avian influenza: Theoretical foundations of current empirical research Conducting behavioral research on Amazon's Mechanical Turk Why social distancing is so difficult; How research explains our behavior Internal reputation management: The impact of authentic leadership and transparent communication Excellence in internal communication management Trust influences response to public health messages during a bioterrorist event See which states and cities have told residents to stay at home. The New York Times Political parties and confidence in government: A comparison of Norway, Sweden and the United States State action on Coronavirus (COVID-19) Crossover effects in the theory of reasoned action: A moderating influence attempt Relationships among attitudes and subjective norms: Testing the theory of reasoned action across cultures Consumer acceptance of electronic commerce: Integrating trust and risk with the technology acceptance model Understanding and predicting electronic commerce adoption: An extension of the theory of planned behavior Staying at home or going out? Leadership response to the COVID-19 crisis in Greece and Sweden Most Americans say Coronavirus outbreak has impacted their lives The 2009-2010 influenza pandemic: Effects on pandemic and seasonal vaccine uptake and lessons learned for seasonal vaccination campaigns A social-cognitive model of pandemic influenza H1N1 risk perception and recommended behaviors in Italy Tuning in, tuning out: The strange disappearance of social capital in America Exploring communication, trust in government, and vaccination intention later in the 2009 H1N1 pandemic: Results of a national survey Risk, uncertainty and the theory of planned behavior: A tourism example Give the emperor a mirror: Toward developing a stakeholder measurement of organizational transparency The social amplification/attenuation of risk framework: Application to climate change Effective communication during an influenza pandemic: The value of using a crisis and emergency risk communication framework Crisis and emergency risk communication as an integrative model Historical origins of the health belief model Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: Cross sectional telephone survey Behavioral intention formation: The interdependency of attitudinal and social influence variables Social-cognitive factors in changing health-related behaviors Communicating in times of uncertainty: The need for trust Test of a trust and confidence model in the applied context of electromagnetic field (EMF) risks Public attention to extreme weather as reflected by social media activity The perception of risk The public's response to the 2009 H1N1 influenza pandemic A gender-sensitive approach to US crisis communication for COVID-19 and beyond CDC's credibility is eroded by internal blunders and external attacks as coronavirus vaccine campaigns loom. The Washington Post Talent, diversity and growing expectations Confidence in crisis? Understanding trust in government and public attitudes toward mandatory state health powers Values, attitudes and interpersonal behavior Public perspective on the governmental response, communication and trust in the governmental decisions in mitigating COVID-19 early in the pandemic across the G7 countries Effective health risk communication about pandemic influenza for vulnerable populations Predicting response to reassurances and uncertainties in bioterrorism communications for urban populations in New York and California Effects of government dialogic competency: The MERS outbreak and implications for public health crises and political legitimacy A study on dialogic communication, trust, and distrust: Testing a scale for measuring organization-public dialogic communication (OPDC) The effects of blog-mediated public relations (BMPR) on relational trust Understanding motivated publics during disasters: Examining message functions, frames, and styles of social media influentials and followers