Information Sources Used by Students Regarding COVID-19: A Cross-sectional Study

In December 2019, the world faced a critical new public health stressor with the emergence of SARS-CoV-2. The disease spread so rapidly that it impacted the management of healthcare in countries around the world for weeks (1, 2). The COVID-19 pandemic has created new situations that require effective communication of health information worldwide. Providing clear, consistent, and trustworthy information about the pandemic is crucial to contain and control the pandemic (3). It is important to use fast, reliable sources of information (4). The importance of effective communication strategies to improve the population's level of information has been demonstrated in recent years with the outbreak of epidemics such as Ebola, Zika, influenza, and dengue fever (5). Reliable and well-selected health information sources can increase people's knowledge and thus improve their health beliefs and affect their precautions (6, 7). On the other hand, mistrust of information sources can also harm audience acceptance (7). For emerging diseases, unlike chronic diseases, there is no scientific certainty about the information associated with the disease due to a lack of access to medical and public health information, and the existence of numerous and diverse channels complicates this problem (8). The uniqueness of this study lies in the examination of these dynamics among Iranian university students, a population with high digital literacy but facing unique cultural barriers to information trust.

This study was conducted to identify the main sources of information used by students regarding COVID-19 and to evaluate their perceived reliability. The aim is to inform the development of effective health communication strategies specifically tailored to this population.

The study sample consisted of 391 university students, mainly from medical sciences backgrounds, with an average age of 25.13 ± 6.42 years. The majority of participants were female [245 (62.70%)], which is in line with the typical gender distribution in Iranian higher education. Most were married [311 (79.50%)], which may be influenced by cultural norms and the older age of undergraduate cohorts in the region. In terms of education, undergraduates were the majority [291 (74.40%)], while graduate students made up a smaller percentage [100 (25.60%)]. The field of study was heavily focused on medical sciences [328 (83.90%)], with non-medical sciences being less represented [63 (16.10%)], potentially impacting perceptions of health-related information sources. Table 1 offers a comprehensive summary of these demographic variables, including marital status, GPA, education level, and field of study.

4.5. Summary of Key Findings

Figure 1 summarizes the key findings on convenience and trust across major sources, visually highlighting the paradox of high accessibility for social media contrasted with low trust levels.

Figure 1.

Summary of key findings on accessibility vs. trust in COVID-19 information sources: Bars represent percentages of "high" ratings for convenience/accessibility (teal) and trust (orange) from Likert scale responses [data is from Tables 2 and 5 (n = 391); multiple responses are allowed; highlights paradox: High convenience (e.g., 61.4% for social media) vs. low trust (5.1%)].

This study extensively explored COVID-19 information sources among students from various Iranian universities. The findings indicated that the primary sources of COVID-19 information for students were international messengers and social media, domestic scientific websites, international scientific websites, and healthcare workers. These results align with established patterns seen in the literature, emphasizing the prevalence of social media as the most frequently utilized information source among students (12-15) . Recent studies indicate a shift in preferred information channels during crises towards online news or social media (15-17). However, past epidemic research emphasizes the pivotal role played by traditional media like television and newspapers in heightening public awareness and shaping health issue comprehension (8, 18). Although social media can effectively promote preventive measures, the development of literacy skills is crucial for its optimal utilization. Further investigation is warranted to explore how specific social media platforms influence preventive behaviors, particularly in the context of misinformation, which was prevalent during the COVID-19 pandemic (19). Our findings highlight a novel paradox in Iranian students: High accessibility of social media but low trust, which contrasts with studies in Jordan, where social media was both primary and somewhat trusted (13). Similarly, in Palestine, Baker et al. reported trust in the WHO but reliance on social media, aligning with our emphasis on international sites (15). In Japan, Uchibori et al. found that traditional media is more trusted, suggesting cultural differences in digital adoption (19). Trust in information sources significantly impacts public responses, especially during health crises. Misleading information on vaccinations, deaths, and lockdowns can trigger panic buying of essential goods, disrupting supply chains (20). This study highlights the reliance on international scientific websites and databases by most participants, consistent with Friedman et al., who noted government sources like the CDC, FDA, and local health departments as most reliable for the general public (21). In contrast, Zhong et al. identified social media as a primary COVID-19 source for patients, with health professionals most trusted (22), while this study and a Saudi Arabian non-pandemic investigation revealed low trust in international messengers and social media, favoring healthcare professionals (6). This discrepancy suggests that while social media is accessible, its unverified content undermines trust, necessitating strategies such as collaboration with social media platforms to implement fact-checking algorithms and promote verified health information from sources like the WHO or CDC.

The study highlighted students' preference for international messengers, social media, and traditional media as the most accessible information sources. Another research indicated that social media, websites, and internet engines were also easily accessible (23). Notably, social media emerged as the most extensively used and convenient source in this study, but lacked trustworthiness. Given the study's focus on young people with high internet and social media usage, the unfiltered nature of news on these platforms led to skepticism regarding their reliability. To address this, policymakers should prioritize partnerships with social media platforms to enhance content moderation and promote credible sources, reducing the spread of misinformation that could exacerbate public health crises.

Interestingly, to our knowledge, few studies have specifically evaluated the perceived usefulness of information sources. However, the present study observed a pattern of alignment between trust and perceived usefulness. Across the data, sources rated highly for trustworthiness (e.g., international scientific websites) were consistently also rated highly for usefulness. This suggests that students may perceive trustworthy sources as more applicable to their needs. This descriptive observation underscores the potential interplay between trust and utility in health information seeking, warranting future correlational analyses.