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Health Crisis in the Kingdom of Saudi Arabia

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Health Crisis in the Kingdom of Saudi Arabia HEALTH CRISIS IN THE KINGDOM OF SAUDI ARABIA: A STUDY OF SAUDIS’ KNOWLEDGE OF CORONAVIRUS, ATTITUDES TOWARD THE MINISTRY OF HEALTH’S CORONAVIRUS PREVENTIVE CAMPAIGNS, AND TRUST IN CORONAVIRUS MESSAGES IN THE MEDIA Saud Abdulaziz Alsulaiman A Dissertation Submitted to the Graduate College of Bowling Green State University in partial fulfillments of the requirements for the degree of DOCTOR OF PHILOSOPHY May 2018 Committee: Terry Rentner, Advisor Per F. Broman Graduate Faculty Representative Lara Lengel Lisa Hanasono © 2018 Saud Alsulaiman All Rights Reserved iii ABSTRACT Terry Rentner, Advisor As of September 2017, more than 600 people died in the Kingdom of Saudi Arabia (KSA) since the Coronavirus outbreak in 2012. The Ministry of Health (MOH), in cooperation with international health organizations such as the World Health Organization (WHO), launched a public health campaign to increase awareness of preventive measures. Initial responses from this campaign left people confused by the mixed messages disseminated and led to distrust of the MOH and its website, the primary source for communication to the public. A new minister launched a comprehensive campaign that incorporated key messages, trustworthy sources, and specific actions. The purpose of the study was to explore whether the MOH in Saudi Arabia has implemented best public relations practices during a major health crisis or not. The study adapted Champion’s Health Belief Model (HBM) and Meyer’s Media Credibility Scale to formulate an online survey of 875 students from King Saud University in Riyadh, Saudi Arabia administered in summer 2016. The survey addressed HBM preventive behaviors, effectiveness of the We Can Stop It campaign on behavioral changes, and the credibility of Coronavirus messages. Results show that Saudis with higher susceptibility, severity, cues to actions, and self- efficacy scores are more likely to adhere to the MOH’s Coronavirus preventive measures than those with lower scores. Respondents with high perceived barriers are less likely to adhere to Coronavirus preventive measures. The MOH’s website is the most credible source of Coronavirus information followed by the WHO and MOH’s Twitter account. Internet search iv engines followed by the MOH’s communication channels, like their website, Twitter, and Facebook, are the first places Saudis visit when seeking Coronavirus information. The increasing adherent practices of the MOH’s Coronavirus preventive measures, like washing hands frequently, show how the MOH was successful of regaining trust through effective communication strategies and health interventions. Nonetheless, some Coronavirus preventive measures, such as following a healthy and balanced diet, have not been adopted by the Saudi people. Principles of crisis communication and Grunig’s two-way communication model served as foundations for comparing and contrasting its current “We Can Stop It” campaign. Lessons learned and recommendations are provided. v I would not be Dr. Saud without the full support and encouragement from my precious parents, beloved wife, and special advisor. Thank you all for being in my life. vi ACKNOWLEDGMENTS First and foremost, I am thankful to my God who gives me the strength and patience to achieve my goals so far in this life. This dissertation would not have been possible without the support of amazing people in my life. Thanks to my advisor Dr. Terry L. Rentner who guided me throughout my study and provided me with support and encouragement. It has been an honor to work with Dr. Rentner during this challenging yet beautiful journey. I really appreciate her contributions of constructive ideas, feedback, and time that have made me not only a better researcher but also a better person. If there is only one thing to say about Dr. Rentner, I would say she is the best of the best. She never underestimates any ideas or any research projects I have in mind; instead, she always encourages me to advance my ideas and provides me with excellent resources to help me achieve my goals. I will not forget how she dedicated her time to make me present in prestigious conferences and publish in respected journals. I am sure my journey with Dr. Rentner will not end here, and I hope to cooperate in more research projects in the future. I am also so thankful to have Dr. Lara Lengel and Dr. Lisa Hanasono in my committee, whose knowledge and experience in the health communication field served at best in this study. Both Dr. Lengel and Dr. Hanasono have provided very excellent and valuable feedback that thrived this study with new and different perspectives. Big thanks to Dr. Per Broman who was very supportive, enthusiastic, and provided different and unique points of view. I am also grateful to Dr. Sadik Khuder from the University of Toledo for his efforts, guidance, and support in analyzing the statistical data. I am also grateful to my lovely wife, Dr. Fatimah, who has supported and encouraged me to success in my life. She has lived and experienced every challenge, happiness, and joy I have had during my journey of pursuing higher education. Without her, I would not be writing these vii acknowledgments right now. Also, big thanks to my lovely daughters, Reem and Dania, who endured all the challenges and difficulties that took me from their times. Thanks also to my parents and my family for their endless supports and prayers. I am so thankful to have these loving and nurturing people in my life. Finally, I would like to thank the Department of Mass Communication, College of Arts, at King Saud University for their support during my study. viii TABLE OF CONTENTS Page INTRODUCTION………………………………………………………………………..... 1 CHAPTER I. REVIEW OF LITERATURE ....................................……………………… 6 Coronaviruses Middle East Respiratory Syndrome (MERS) in KSA ....................... 6 The Ministry of Health’s Efforts to Reduce Coronavirus .......................................... 9 Coronavirus preventive measures .................................................................. 13 Public Relations Practitioners & Public Campaigns .................................................. 17 Phases of campaign development .................................................................. 20 Public Relations & Health Campaigns ...................................................................... 22 Crisis Communication ............................................................................................... 28 Crisis Communication and Social Media .................................................................. 32 Using Social Media in Health Organizations ............................................................. 36 Media Credibility ....................................................................................................... 43 The credibility of news organizations ............................................................ 44 CHAPTER II. THEORY ...……………………………………………………………….. 47 Grunig’s Four Models of Public Relations …………………………………………. 47 Health Belief Model (HBM) ..................................................................................... 54 Elaboration Likelihood Model (ELM) ....................................................................... 59 CHAPTER III. METHODOLOGY ................................................………………………. 65 Survey Research ......……………………………………………………………….. 65 Online survey ................................................................................................. 66 Research Design, Population, and Sample .............................................................. 69 ix King Saud University (KSU) ..................................................................................... 69 Instrumentation .......................................................................................................... 71 Procedures……………………………………………………. ................................. 74 Validity of HBM coronavirus scale ............................................................... 74 IRB approval ………………………………….. ........................................... 75 Data collection ............................................................................................... 76 Data analysis .................................................................................................. 76 CHAPTER IV. RESULTS ......................................................……………………………. 77 Characteristics of Subjects ........................................................................................ 78 Instrument Reliability ................................................................................................ 80 Frequency of HBM’s Five Dimensions ..................................................................... 81 Perceived susceptibility ................................................................................. 81 Perceived severity .......................................................................................... 81 Perceived barriers........................................................................................... 81 Perceived benefits .......................................................................................... 82 Cues to action ................................................................................................. 82 Self- efficacy .................................................................................................. 82 Frequency Distributions of Media Credibility ..........................................................
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