THE EXPERIENCE OF COVERING COVID-19 RECOMMENDED HEALTH BEHAVIORS FOR FILIPINO-AMERICAN ETHNIC MEDIA By Adrian Kresnak A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of Health and Risk Communication – Master of Arts 2024 ABSTRACT This thesis studies health journalism in Filipino-American ethnic media during the early years of the COVID-19 pandemic. Using Communication Infrastructure Theory and Diffusion of Innovation Theory, I explore how journalists in these media communicated health recommendations. The results indicate that journalists perceive their audiences to be receptive to official health guidance and willing to help others in times of crisis. The cultural spirit of bayanihan is discussed in relation to Filipino-American ethnic media. The timeframes of continuing health messaging also show some importance. Copyright by ADRIAN KRESNAK 2024 ACKNOWLEDGMENTS I want to express my gratitude to my advisor, Bruno Takahashi, and my committee members, Susan McFarlane-Alvarez and James Dearing. Thank you for your guidance and support in this project. Thank you to Professors Joe Grimm, Alex Allweiss, and John Sherry for their encouragement and support in my academic career. You helped me through difficult times. Thank you also to my parents Bill and Sheryll, and brother Joshua. I am so proud to present this work to you. Thank you to my long-distance friends June, Mer, Sango, and Oly. I’m so happy I got to share this time with you all. iv TABLE OF CONTENTS CHAPTER 1: INTRODUCTION ................................................................................................... 1 CHAPTER 2: LITERATURE REVIEW ........................................................................................ 3 CHAPTER 3: METHODS ............................................................................................................ 12 CHAPTER 4: RESULTS AND ANALYSIS ............................................................................... 17 CHAPTER 5: CONCLUSIONS ................................................................................................... 29 BIBLIOGRAPHY ......................................................................................................................... 32 v CHAPTER 1: INTRODUCTION The President of the United States declared the beginning of the COVID-19 national health emergency in the United States in March 2020. The proclamation was allowed to lapse in May 2023 (Coronavirus: Timeline, n.d.d.). Public health officials recommended multiple health behaviors to address COVID-19. Some of these recommendations reflected previous flu recommendations, such as vaccination or hand-washing. One of the recommendations was masking, where individuals wear face masks around others to avoid spreading disease. Masking was not common in everyday life, so this recommendation became an innovation to the American public. This innovation was adopted unevenly throughout the American population (Rader et al., 2021). One barrier to adoption for some sub-populations was a perceived cultural conflict between what masks represented and American values (He et al., 2021), a conflict worsened by some political rhetoric blaming foreigners for the disease. Because the first known cases occurred in China, this rhetoric blamed Chinese people in particular and Asian people in general (Grunawalt, 2021). People of Asian descent living in the United States became a focus of media attention, and the organization StopAAPIHate formed to track anti-Asian hate crimes in the United States. Developing communication campaigns includes defining the target audience. Communication professionals can develop messages with the audience’s cultural and historical contexts. The COVID-19 pandemic created a context where health messaging to Asian- Americans existed in the context of anti-Asian rhetoric. My research explores what health journalism looked like in this context. I am focusing on Filipino-Americans, a sub-category of Asian-Americans, because they are less represented in literature. Filipino-Americans as a 1 demographic have other important traits also. Many work in the American healthcare system (Zarni, 2023), including immigrants from the Philippines. I’m researching this for a personal reason as well. I am of Filipino descent and identify as Filipino-American. My mother writes for the Hawaii Filipino Chronicle. Recently I have begun contributing there also. In summary, this study will explore how Filipino-American journalists experienced and covered the COVID-19 pandemic. I specifically examine Filipino-American ethnic news media. Using Communication Infrastructure Theory and Diffusion of Innovation Theory, I explore how the journalists communicated health recommendations during a time of uncertainty and misinformation. Research Aims This study asks how Filipino-American journalists saw their respective newspapers’ roles in their communities. It also asks how the journalists reported on COVID-19 mitigation recommendations with a focus on the use of face masks. I propose that studying how these journalists communicated health recommendations may be useful for future health campaigns. Structure of the Thesis Chapter 1 presents the background of the thesis. Chapter 2 presents the literature review, explaining past research and presenting the theoretical framework. This includes a discussion of Communication Infrastructure Theory and Diffusion of Innovation Theory. Chapter 3 presents the methodology of sampling, data collection, and data analysis. Chapter 4 presents the qualitative results. This includes quotations from the participants. Chapter 5 presents the conclusion of the thesis, summarizing the connection between the theories and the results. 2 CHAPTER 2: LITERATURE REVIEW The “public” of public health is a collective, often conceptualized as diverse groups further made up of individuals. Health communication is not just messaging to a group, but also the messaging within the group. Individuals receive and transmit knowledge in the context of themselves, the communities they identify with, and the groups around them. This chapter is broadly divided into three subsections: Communication Infrastructure Theory (CIT), Diffusion of Innovation (DOI), and the still-developing framework of racial activation. To study health journalism in ethnic news media, I propose a theoretical foundation that combines CIT and DOI in the context of racial activation. Communication Infrastructure Theory Communication Infrastructure Theory describes how minoritized populations acquire and use information. The theory argues that minority populations use storytelling to build a sense of community, share tangible resources, and communicate information (Ball-Rokeach et al, 2001). Communication infrastructure consists of interpersonal relationships, community organizations, and ethnic media (Lim et al., 2022). This infrastructure forms “storytelling networks” that encourage and support community health. In their 2001 paper, Ball-Rokeach et al. explored how people begin to identify with their local neighborhoods through local storytelling. When a person from one household talks to a person from another, their conversation could have various topics. The researchers model how, when the individuals tell each other stories about local topics (such as a neighborhood party or crimes in the area), they build a shared identity as members of the neighborhood. Here “telling stories” means narrative communication. The researchers theorize that individuals can build a shared identity as members of larger communities by listening to and telling stories about topics 3 concerning the larger community. Communication infrastructure refers to how the storytelling takes place, with two components: the communication action context and the multilevel storytelling system. The communication action context refers to the features that encourage or discourage communication. Ball-Rokeach et al. give examples of these features. Physical features refers to where people are and where they will come across others. This includes places people can gather, such as parks and libraries. Psychological features are the individuals’ mindsets around interacting with each other. Sociocultural features include demographic identities, political leanings, and cultural attitudes toward interaction. Economic features are the resources available to devote to interacting with others. Technological features are the communication technologies available to individuals, such as phone or internet access. All the features can change, influenced both by internal and external factors. Communication action context features are present at all levels of the multilevel storytelling system. The multilevel storytelling system refers to the different spheres of communication. Ball- Rokeach et al. name three levels. First, macro-level storytelling concerns city-wide or higher communication. This usually includes mainstream media. Second, meso-level storytelling concerns local organizations and media. This can include ethnic media when it specializes in specific areas. Third, micro-level storytelling consists of interpersonal interactions. The levels of storytelling do not depend only on the size of the media, but also on its focus and intended audience. A story about a neighborhood, for example, will appear differently in that community’s meso-level storytelling (where the residents are the intended audience) than it would in macro- level storytelling (where the residents may or may not be considered in the target audience). Media and personal interactions form the community’s storytelling networks. 4 Communication Infrastructure Theory holds that storytelling networks help individuals develop a sense of belonging. Connection to storytelling networks is correlated to higher civic activity and political trust (Lee et al., 2023). Civic activity and political trust promote social cohesion, which in turn is helpful for health communication. Strong storytelling networks can help reach communities that don’t speak the mainstream language, such as English-language COVID-19 coverage being translated for Spanish-speaking audiences (Wenzel & Crittenden, 2023). The journalist translators bridged a gap between English-language and Spanish-language media. It should be noted that translating news does not necessarily mean creating culturally- relevant news; ethnic media includes more than the language used. Ethnic media is media developed by and for specific ethnic groups. This allows for stories that are both culturally and geographically relevant to their target communities. Differences in ethnic and mainstream media help minority audiences build a sense of ethnic identity (Ramasubramanian et al., 2017). “Ethnic media” can refer to both fiction and nonfiction. For the purposes of this paper, I use the phrase to refer to ethnic news media. Health journalism in ethnic news media shares information about illnesses, allows individuals to find tangible support, and places health in context for the community (Bernadas et al., 2023). Community-focused journalistic narratives can empower communities to take action to protect their health (Brown et al., 2019). Health journalism in ethnic media has differences from “mainstream” media; for example, ethnic media has been found to report on cancer with a focus on preventative behaviors in contrast to mainstream media (Stryker et al., 2009). Sources in ethnic news media are likely to be more relevant to local communities (Casillas et al., 2023). The narrow focus of “local” news may be a moderating factor, as ethnic and non-ethnic local news media have been found to cover health topics similarly (Wang & Rodgers, 2013). 5 Filipino-American ethnic media has a long history. Filipino professionals immigrated in a wave in the 1960’s, and by1972, there were at least 12 active Filipino-American publications (Hart, 1977). The subscription-based magazine Filipinas magazine debuted in 1992. Filipinas aimed for an immigrant audience, bridging international cultural values (Sarabia-Panol, 2006). The magazine ceased print publication in 2010 amid the financial struggles related to the 2008 recession. In this thesis, I used Communication Infrastructure Theory in my analysis of the journalists’ interviews. I examined how their reported experiences fit within the communication infrastructure of their communities during the pandemic. This is a partial application of the theory. Diffusion of Innovation Diffusion of Innovation Theory refers to the process by which a population adopts or does not adopt an innovation new to them (Rogers, 1995). Innovation can mean physical inventions, behaviors, philosophies, or any new thing. Different parts of a population learn the existence of an innovation and adopt it at different rates. Information about an innovation moves through multiple communication channels. The multiple channels are important because people at risk from specific factors (such as unknowing exposure to infection) may be unaware of the risks and unlikely to seek out information about it. Individuals at risk from environmental factors adopt preventative behaviors if the behavior is presented by a trusted source (Griffin & Dunwoody, 2000). The knowledge gap hypothesis says knowledge is distributed unevenly in society, with higher-status populations acquiring more information and faster than those from lower status (Lind & Boomgaarden, 2019). This hypothesis poses systemic differences in how high-status and low-status populations receive information. These differences relate to the 6 resources available for seeking information. Different kinds of media communicate different information and have different levels of accessibility. Knowing which channels a population uses helps health officials to communicate with them (Beacom & Newman, 2011). This is important because it helps address social inequities caused by unequal access to information. This thesis reports on some papers’ respective strategies for distributing information to Filipino-American communities. During the COVID-19 pandemic, public health officials recommended “universal masking,” where all individuals wear face masks in public settings. Universal masking was uncommon in the United States before the pandemic, so the behavior became a subject of discussion in public discourse. Social media posts encouraged masking in the early part of the pandemic. As the pandemic continued, the prevalence of encouraging posts decreased (Long et al., 2023). Multiple rhetorical strategies were present in tweets both encouraging and discouraging the use of masks (Low et al., 2023). Masking became a political issue, with some politicians invoking authoritarian Asian governments in their rhetoric (Grunawalt, 2021). This was the context of media messaging about COVID mitigation behaviors. Journalists reporting on previous health crises have shifted their roles from watchdogs to public mobilizers (Klemm et al., 2019). In their 2022 paper, Chen and Koo compared journalists’ roles and framing of COVID-19 stories in Chinese, South Korean, and American media. They found American journalists were more likely to use uncertainty and conflict framing in reports about government response. Journalism culture in different countries can influence how they present medical innovations to their audiences. The Designing for Diffusion Framework for Global Health Innovations model describes how innovations get adopted across country lines (Shin et al., 2022). The framework describes six factors and their associated sub-factors. One of the factors is 7 the presence of “linking agents,” individuals and organizations that introduce the innovation to the country of interest. News media is one such linking agent. The international aspect of Filipino-American communities (as described below) places Filipino-American ethnic media in a position to diffuse global health innovations. This is one reason I believe my research topic is worthwhile for health communication research. In this thesis, I applied Diffusion of Innovation Theory to my analysis. I examined how the journalists conceptualized the use of face masks and their journalistic responsibilities in writing about health recommendations. This combines with Communication Infrastructure Theory in news media’s role as an introduction to innovations. This is a partial application of Diffusion of Innovation Theory. Racialization and Racial Activation Racialization is the process of assigning racial identity, often but not always to establish social power (Omi & Winant, 1986). A person may be racialized by others from their appearance. An object may be racialized when it is identified with a racial group, such as certain rice dishes being identified as “Asian food.” As this example shows, racialization is not necessarily harmful. Face masks as a symbol of oppressive Asian governments can be traced back to the SARS outbreak of 2002-2003, where U.S. media included images of masked Chinese citizens amidst criticism of the Chinese government (Sin, 2014). COVID-era anti-mask protests in the United States framed mask-wearing as a government-imposed limit on individual freedom (Grunawalt, 2021). This is at odds with the experiences of Asian people living in Asian countries, where at times individuals wore masks against government instruction (Fearnley & Wu, 2023). Activists Emma Gee and Yuji Ichioka developed the “Asian-American” identity in 1968 amid the Civil Rights Movement (Kambhampaty, 2020). This term synthesized discrete ethnic 8 groups into a pan-Asian identity for the purposes of political coalition. Today, the term “Asian- Americans” includes both natural born American citizens of Asian descent as well as immigrants from other countries. Members of different Asian ethnicities vary in how they perceive this panethnic identity. Higher income and political activity levels are correlated with a higher identification with Asian-American identity (Masuoka, 2006). Asian-Americans experience racialization, including racialized narratives. The “perpetual foreigner” narrative frames Asian-Americans as outsiders, separated from mainstream American culture by their perceived cultural differences (Armenta et al., 2013). Anti-Asian rhetoric during the COVID-19 pandemic, and specifically anti-Chinese rhetoric, framed Asian bodies as not only foreigners, but contagious ones (Nham & Huỳnh, 2020). Pre-existing racism against Asian- Americans intensified (Williams et al., 2023). This form of racialization, where an individual’s racial identification becomes more salient to themselves and others, is called racial activation (Oh & Min, 2022). Racial activation influences the experiences of racialized people based both on how they identify themselves and on how others identify them. Multiple factors can trigger racial activation, particularly for intersecting identifications. Oh and Min (2022) studied journalists of East Asian descent working in predominantly white/male newsrooms. East Asians are one group among many under the Asian-American umbrella. My study will focus on Filipino-American journalists, who are of Southeast Asian descent. Filipino-Americans in the United States have a historical and continuing relationship to the country’s healthcare system. Filipino immigrants make up 33% of all foreign-born registered nurses working in the United States (Zarni, 2023). Filipino culture includes bayanihan, collective action for the benefit of the community. While the concept of community members helping each other is not unique, what makes 9 bayanihan distinctly Filipino is a connotation of resilience. Community members work together particularly when outside entities are unavailable, untrustworthy, or antagonistic (Bersamira & Macaraeg, 2022). Narratives around bayanihan have been criticized as covering up the lack of governmental responsibility to small communities (Su & Thayaalan, 2023). In this thesis, I study how Filipino-American ethnic media journalists communicated health information in light of pandemic-related racial activation. I studied masking as the focus innovation and the journalists as members of their communities’ communication infrastructure. I intend this blend of theories to give me insights into the experience of diffusing innovations in minoritized communities. It allows me to explore how the cultures of the Philippines and the United States influence Filipino-American health journalism, the challenges for ethnic media during this time period, and how journalists approached politicized health information. Summary Public health messaging has to reach populations outside of the mainstream public. News media is one way individuals can discover health-related information. Ethnic news media focuses on and is used by minority populations. Masking to mitigate COVID spread is a public health behavior that had cultural barriers to mass adoption. The cultural barriers reflect the anti- Asian sentiments reported in mass media. By learning how journalists in ethnic media covered masking, we may gain useful information for future public health communication. Research Questions Based on the theoretical concepts described above, I propose the following research questions: RQ1. How did Filipino-American journalists writing in ethnic media conceptualize their responsibilities as professionals in their communities during the beginning of the COVID-19 pandemic? 10 RQ1.a How did they conceptualize their respective news organizations’ positions within their communities? RQ2. How did journalists decide what information about mask-wearing they should communicate to their audiences? RQ2.1 What methods did they used to decide how to communicate this information? 11 CHAPTER 3: METHODS To answer the research questions, I decided to use a qualitative approach. Qualitative methods allow for exploration of experience through the participants’ own words. This chapter is divided into three subsections: review of news outlets, sample and data collection, and data analysis. I used a qualitative analysis approach, specifically thematic analysis of interview data. Review of News Outlets I searched Filipino-American ethnic news media on Google and found papers around the country. My research criteria for news outlets was as follows: 1. They were news outlets; 2. They self-identified as Filipino-American; 3. They published articles sometime between 2020-2023; and 4. They had at least one article about “health.” I found 15 papers that fit my research criteria. Some of these papers were the Hawaii-based Hawaiian Filipino Chronicle and Fil-Am Courier, the Pacific Northwest-based Fil-Am Chronicle, and the online-based Positively Filipino and Fil- Am Tribune. On each paper’s website, I searched for the keywords “pandemic,” “masks,” “coronavirus,” and “COVID-19.” If the website had a “health” category, I looked through it also. I chose articles published between 2020-2023. I disregarded articles that were credited to outside organizations rather than individual journalists. If an article was credited to “editors” or “staff,” I kept the article under consideration while trying to find the writer(s). When I found an individual journalist who had written an article of interest, I noted their name, contact information, the newspaper they wrote for, the state the newspaper was based in and the state the writer was based in. 12 Sampling and Data Collection I read news from all the outlets matching my research criteria to familiarize myself with the outlets and their journalists. I reached out at first to individuals who had written about COVID-19 or masking, then to people who had written about anti-Asian sentiment around the pandemic. One of the journalists died before I could contact them. I contacted 10 people through email, with two follow-up emails over the next month. I contacted two people through LinkedIn. I contacted two through Instagram. I contacted 11 through Facebook. Finally, one participant introduced another to me. In total, I sent messages to 26 people and received responses from 12. I was unable to schedule an interview with five for various reasons, mostly having to do with timing issues. I interviewed seven journalists from a total of three Filipino-American newspapers. This sample size is small, so the conclusions of this study are tentative. The reporters wrote for papers based in California, Hawaii, and Virginia. The journalists mostly lived in the United States (U.S.), with two currently living in different countries. None of them worked full-time for their newspaper. The levels of experience ranged from recent college graduates to those who had been in journalism for more than two decades. Some worked in the healthcare field or had close relatives who did. Table 1 includes more characteristics of the participants. I attempted a reconstruction interview method with participant D. Reconstruction is a qualitative method for semi-structured interviews. Researchers read articles written by the participants, then interview the journalists about their processes when developing the articles (Van Witsen & Takahashi, 2021). This method allows researchers to explore the experience of journalism and how it influences the final product. I did not use this method with the other 13 participants because they did not recall the specific process of writing the articles I wished to ask them about. I discuss the limitations of this methodology in the conclusion section. I categorized the journalists I spoke to into two groups. “Contributors” primarily wrote articles for their papers. Most reported on external news. Some described their writing as reporting their own perspectives, placing themselves as subjects in their stories rather than external observers. “Editors” were primarily involved in the editorial part of the newspaper as well as reporting. I spoke to four contributors and three editors. I asked them about their experiences in and out of the newsroom, their use of sources, and how they decided which messages to include in their reporting. The questions are designed to capture the experience of health journalism for their ethnic community (Bhattacharya, 2017). My pre-written questions included how their reporting changed under government protocols, how they felt about recommended COVID mitigation behaviors, and what their experiences were (if any) with anti- Asian incidents. During the interviews, I followed up the journalists’ answers with related questions. Some examples of the kinds of questions that came up include: how they reported on financial hardships, how they reported on emotionally sensitive subjects, and what they consider “back to normal.” Six interviews took place over teleconferencing software and one over the phone. I recorded these interviews with the journalists’ permission and had them transcribed by a human transcription service. The interviews lasted on average 38 minutes and ranged from 22 to 57 minutes. 14 Table 1: Characteristics of Participants ID State where their paper is headquartered Position Gender Years experience in journalism A California Editor Female ~5 B California Contributor Female ~5 C California Contributor Female ~3 D Hawaii Editor Female ~5 E Hawaii Contributor Male ~20 F Hawaii Contributor Female ~5 G Virginia Editor Male ~30 Coding & Analysis I analyzed the interviews using the hybrid approach of inductive and deductive thematic analysis described by Swain (2018). In this method, codes are identified both before and after the data is collected. This allows the researcher to find themes relevant to their research questions while leaving space for unexpected discoveries. For the deductive themes, I considered how a journalist might consider their paper’s relationship to their audiences and what health messages the journalists themselves were receiving. This led to codes such as “solidarity,” “political figures,” “health officials,” and “disability justice.” My coding around anti-Asian racism was divided into “racism” and “racial justice.” I coded the journalists’ answers under these depending on whether they focused on harm done or attempts to address harm. 15 The coding took place over three rounds. The first round was on paper copies of the transcripts. The unit of analysis for this round was words and phrases. Prior to conducting the interviews, I had created a list of codes that reflected the questions I prepared. After getting the transcriptions, I printed them out and highlighted parts that fell under the codes. I also noted emerging themes and added them to the coding list. One theme was bayanihan, the Filipino term for community support in times of crisis. Codes that fell under this included “public community” and “tone of stories”. Another was their experiences of stay-at-home orders (“lockdowns” or “quarantines”) and how those influenced their perception of the timeline of the COVID-19 pandemic. For the second round, I read the transcripts on Microsoft Word and did the coding on a Google Docs document. The unit of analysis for this round was full sentences. I reread the interview transcripts to cut and paste parts that fell under the codes. This allowed me to capture the context of certain recollections and opinions. I noted when the participants repeated themselves, particularly when answering different questions. For example, one participant spoke about quickly-changing government protocols in multiple answers. I noted each time under the primary theme of the answer. For the third round, I read the interviews one more time on Microsoft Word and hand- wrote my analysis. The unit of analysis for this round was once again words and phrases. This allowed me to connect the themes between interviews. With the prior rounds in mind, I connected the context of keywords across interviews. For example, the journalists’ experiences of stay-at-home orders varied even when they were in the same state. I wrote key terms they used and one-sentence summaries of their descriptions. 16 CHAPTER 4: RESULTS AND ANALYSIS The interviews gave me insights into the experiences of Filipino-American ethnic press journalists during a public health crisis. I have categorized these insights into two main sections. The first applies Communication Infrastructure Theory to the journalists’ perception of their newspapers, examining pandemic-era community and bayanihan. The second applies Diffusion of Innovation Theory to the journalists’ perception of masking and health journalism, with themes of internationality and time. Racial activation influences both sections. Communication Infrastructure Theory and Pandemic-Era Community My first research question asks how Filipino-American journalists writing in ethnic media conceptualized their responsibilities as professionals in their communities during the beginning of the COVID-19 pandemic. A sub-question was how they conceptualized their respective news organizations’ positions within their communities. Communication Infrastructure Theory (CIT) describes how minoritized communities share information in the communication action context of their environment. The COVID-19 pandemic brought changes to various communities’ communication environments, both negative and positive. One change was in the limitation of movement under government restrictions (sometimes called “lockdowns” or “quarantines”). Previous research identifies inadequate communication about COVID-19 restrictions as a source of tension across diverse audiences (Lowe et al., 2022). Members of Black and Latino Philadelphia communities expressed frustration in the difficulty of finding relevant local information (Wenzel & Crittenden, 2023). The journalists I interviewed described their experiences from 2019 onward in ways that reflected this prior research. 17 The journalists’ respective newspapers had physical versions as well as digital websites. The physical papers were distributed in local small businesses, mostly Filipino stores and restaurants. Making the papers available for free in these areas connected the local media with local residents, building what CIT calls “storytelling networks.” These networks are supposed to facilitate community health by providing relevant information. Journalist G describes his paper as being “directly involved in the issues, whether it's immigration or civil rights or healthcare.” When it came to COVID-19, these networks came under strain. One of the recommended health behaviors to address the disease was “social distancing,” where individuals were encouraged to remain at least six feet apart from others. The journalists spoke of how different levels of government enforced social distancing, including official limitations on movement and gathering. This changed the physical communication action context: because local residents were limited in their movements, there was now a barrier to obtaining physical newspapers. Technological features helped compensate for this. Editorial staff created or updated websites for their organizations. Articles were published both in print and digitally. As Journalist D describes: We hired someone to change our website, 'cause we gotta make sure that people are still reading [our newspaper] even though people are not going out to get our newspaper. So we really had to make sure that our online presence is there. And I think that really helped us to get more, to get advertisers and also writers reaching out to write more, write articles for our paper. Bayanihan “Bayanihan” is a Filipino word used to describe how individuals help each other in times of need (Bersamira & Macaraeg, 2022). (I do not italicize it here because it was used by immigrant speakers in these interviews rather than being a loanword from a language foreign to 18 them.) Journalist E used this word specifically while describing their experience of the COVID- 19 pandemic: There's a sense [of] what we call in the Filipino community, as the bayanihan, is a Filipino term called helping each other or working together, a sense of cooperation, a sense of helping each other out during hard times. So this Filipino value of bayanihan or helping each other together during... especially during times of crisis, health crisis, was really prominently observed. Helping each other out, not only financially, but volunteering. Other participants, while not mentioning bayanihan by name, reference a Filipino culture of community bonds. This sociocultural feature guided how the participants approached their communities as journalists and as individuals. As Journalist B describes: There's pockets of us [Filipino-Americans] throughout California. But I find in my travels, the diaspora is very large, that we really are everywhere. So just more so kind of an emphasis on kindness and solidarity and togetherness. How you would feel towards your own family is what I would extend to the whole entire community. And yeah, just more so anything that would help us in the long run. As somebody that immigrated here, I immigrated here as a child in 2001. So growing up, I definitely feel more distinctly Filipino-American. The pandemic brought opportunities for bayanihan. Social distancing guidelines encouraged people to remain at home as much as possible, causing people to struggle financially from the sudden loss of business as well as mentally from the isolation. Socially distant programs such as drive-through food distribution allowed Filipinos to uphold bayanihan while following recommended health behaviors. 19 The ethnic press itself also became a method of bayanihan. Journalist E told me that his newspaper informed its readers about resources available to them in the midst of the COVID-19 pandemic. He named seniors as a vulnerable group to whom his paper gave targeted information, including senior-specific hours at local grocery stores. Providing this information through mass media helped minimize this group’s potential exposure to disease. [O]f course as a community publication, our role is to serve the interests of the community by providing information, by reporting on incidents that affect the community, by ensuring that our community is aware of the resources that they need. For instance: test kits – that they are able to access these resources. So a lot of information about where to go, how to avail of these benefits, what to do during emergencies and, in terms of anti-Asian hate and violence, how to report them to the police. Journalists D and F each said they believed they had a responsibility as journalists to bring “light” to the readers. For D, this was in contrast to “heavy” articles focusing on COVID- 19 and its effects. For F, this meant a “light in the darkness.” They saw the potential effects of the pandemic on their readers’ mental health, and they wrote as a way to try to support mental wellbeing. Journalist F says: I made sure that there's positivity in what I write to see the light in the darkness, to bring light in the darkness, hope in the hopelessness. And just speak healing during... a time where people are wounded. So my stories were mostly testimonies of people thriving in the midst of a global pandemic. So, well, as a writer, that is really my goal. While trying to support the community in crisis, the newspapers themselves also struggled during the pandemic. The journalists described their papers as non-profits or volunteer organizations operating under limited budgets. Filipino businesses and organizations advertised 20 in them, but amid the financial strain of social distancing protocols, that advertising fell. Both physical and digital distribution had to be done with a budget. Journalist E specifically cited a sudden loss of business advertising as a crisis for his paper, leading to the paper’s closure. Journalist D used free or low-cost website templates to update her paper’s website. One of Journalist D’s recollections was that journalists were “part of the front liners” in the state of Hawaii. “Front liners” had more freedom of movement under government movement restrictions, indicating the importance of their work for public life. The implication is that journalists need to be able to leave their homes to collect information. The study participants all spoke about the responsibility to collect and report accurate information; freedom of movement, while helpful, was not necessary. Some of the journalists found their sources more understanding of remote interviews during this time. Stay-at-home orders were sometimes at odds with health department guidelines. When official protocols were inconsistent, D had to consider health risks when deciding whether to go out: I just cannot go out every time I want to, even though the protocol says I can. You know what I mean? And also I remember in Hawaii, journalists can actually... They're part of the front liners, but [my supervisor] and I and our team didn't really follow that. We, as much as possible, we just stayed at home as well. D stayed home because of another responsibility: protecting the health of others. The journalists told me they avoided unnecessary travel out of responsibility toward community health. They followed health guidelines because they perceived others to be susceptible to severe disease even if they themselves were not. Two of the seven lived with vulnerable family members, giving them a personal reason to minimize the risk of spreading disease. 21 Diffusion of Innovation and Pandemic Health Messaging My second research question asked how these journalists decided what information about mask-wearing they should communicate to their audiences. A sub-question asked what methods they used to decide how to communicate this information. Diffusion of Innovation theory describes how innovations are adopted by a population. Health communication specialists can use it when introducing new technologies or behaviors. The innovation does not have to be a recent invention; it only has to be uncommon in the population of interest. One of the recommended health behaviors in regards to COVID-19 was wearing face masks. The journalists in this study reflected on masks in the multiple communication action contexts, as described by Communication Infrastructure Theory. These contexts shaped how they wrote about health guidance. These contexts included sociocultural aspects of Asian-American identity and political party, economic aspects of running non-profit news media, and the psychological aspects of their personal and professional identities. Journalist C began writing for her paper after responding to an interest call. I wasn't given training. I was given, basically, they have a very, I would say, very detailed handbook that gave me a guideline of how to write as a journalist in the style of their publication. And I guess maybe just a few tips on how to be sensitive about everybody's experience, because from my point of view, it wasn't only a Filipino American newspaper. It also tried to make space for very diverse groups of people. And from what I got from the editor, you know, the guidelines that she gave me, they really gave me kind of a good idea of how to navigate talking to people. And I thought that was enough because before I joined [this paper], I was also writing for a business newspaper in the Philippines. So, it was more like a cultural thing that I had to learn from the handbook, 22 even though it did have some, you know, basic guidelines on how to write an article, how to be sensitive, and all those other things. The volunteer nature of the newspapers means that they do not have specialized health reporters. The contributors reported on their experiences of the pandemic, reporting on the health behaviors they and the people around them were using. I focused on mask-wearing in my exploratory research, but that was only one of the recommended COVID-19 mitigation behaviors. The participants spoke about the behaviors as sets: mask-wearing and vaccination and social distancing, and so on. They named government agencies like the Centers for Disease Control (CDC) as the ultimate sources for their health information. The newspapers publish material from outside organizations alongside original material of the newspapers. Ethnic Media Services is a news organization that provides articles with a focus on ethnic minorities. Other agencies come with different purposes. Journalists D and E named StopAAPIHate as a source providing statistics and articles. Articles credited to the National Asian Pacific Center on Aging informed readers about COVID-19. The Filipino- American newspapers I researched occasionally accept content from non-profit organizations like these even when the writers themselves may not be Filipino. Accepting outside content lowers the burden on editors to obtain enough content for a regularly-published paper, but it also introduces potential problems for the specialized purpose of ethnic media. The journalists made distinctions between their respective papers and mainstream media; they value the difference in content and perspective. Internationality I have used the term “Filipino-American” in this thesis as an umbrella term for both people of Filipino descent who originate in the United States as well as people originally from 23 the Philippines writing for American news media. The individuals I spoke with identified themselves in various ways, including “Filipino,” “Filipino-American,” and “Filipinx.” They used “Filipino” as an umbrella term for people of Filipino descent, speaking of Filipino communities in multiple countries. Four of the participants were originally from the Philippines. One moved back to the Philippines after 2020. Another lived in Asia during the first years of the pandemic and now lives in Europe. They continue to write for U.S.-based news media as a way of telling American readers about international Filipino communities. The contributors who report their own experiences and opinions provide firsthand accounts of life internationally. One participant talked about a paper started by a “newsman from Manila in exile” to inform people in the United States about events in the Philippines. Filipino-American ethnic media crosses borders while maintaining a meso-level storytelling network by focusing on a Filipino diaspora audience. Coverage with an eye for advocacy helps strengthen community identity. In describing her newspaper’s coverage of an anti-Asian incident, journalist A says: After talking to the family and talking to their lawyer and the organizers, we found that there was a much deeper issue that was happening, which was Filipino migrants and Filipino workers not getting the support that they need or the protections that they need while living in the United States. So that's why the focus of the story really brought into something different which was the responsibility of the Philippine consulate to provide resources, the responsibility of the Philippine government to improve the conditions of Filipinos in the Philippines so they do not have to be, so they don't feel that they have to forcibly immigrate to another country to make a living and things like that. 24 The cultural norms of Asian countries reflected in how the journalists approached writing about masking. Masks have been used to spread the disease for decades in countries like China (Sin, 2014) and Singapore (Fearnley & Wu, 2023). I had thought that journalists in this study would feel their audiences needed instruction on the use of face masks. Instead, the journalists showed me they believed their audiences already understood how and why to use masks. They explicitly connected mask-wearing with their readers’ assumed relationships with Asian countries. Racial activation describes when an individual’s racial identity becomes more prominent to themselves or others (Oh & Min, 2022). This did not have as strong a link to mask-wearing as I had anticipated. The participants connected being Asian with wearing masks, but did not connect wearing masks with the anti-Asian rhetoric surrounding COVID-19. Rather, the anti- Asian sentiment became another risk factor in the story of the pandemic. Journalist E described informing his readers about how to protect themselves and report incidents. There were several incidents, especially during the first months of the pandemic, when China was sort of, like considered the source of the pandemic. And that's when this anti- Asian hate and violence became very, very alarming. And certainly we reported on these incidents, and we also made sure that they take safety precautions, like, for instance, not walking by themselves when they come home from the hospital. Making sure that they take safety measures in terms of their transportation, in terms of the movements, in terms of where to go. The journalists’ previous understanding of hygiene norms also appeared. Multiple journalists mentioned hand-washing as a way to prevent COVID-19 infections.The journalists had differing opinions about the appropriateness of washing surfaces: while one recommended 25 washing groceries, another described it as “extreme.” These reflect the uncertainty regarding COVID-19 transmission methods in the early days of the pandemic. Amid this uncertainty, journalists had to determine what health guidance would be truly useful for their readers. They listed hand-washing as part of a set of protective health behaviors. This indicates that hand- washing was diffused through enough of their local populations that it was a norm rather than an innovation. As Journalist E says: “I didn't know very many people who died of COVID, but I knew people who died during COVID, and I don't think the vaccine would've helped them. But masking might have, hand washing might have.” Writing about masks was not so much persuading the reader as much as reminding them. The pandemic was a long-term news story that continuously created other stories. Amid the newsworthy events of the day-to-day, health recommendations remained important information. This contrasts with the journalists’ reported experiences before and after 2020-2023. The journalists described to me their responsibility to ensure their audiences received health recommendations, even when official recommendations and rhetoric changed. The recommendation to wear masks seems to have stuck for the journalists throughout the first years of the pandemic. Journalist D put reminders in her narrative articles. Journalist E wrote about the political aspects of masking and political rhetoric. The journalists did not seem to attach much importance to anti-mask protests. As journalist G says: As an editor, of course [one of] the responsibilities is really on me as an editor to choose what I believe to be the right course as far as what to report. So while I reported on the divisions and contentious disagreements, I also made sure that the truth about the pandemic, about the necessity for taking precautions, to get vaccinated, to avoid being in 26 crowds. I mean, those basic -- basic practices, basic behavior that are fundamental to the health of the community. That's what I strive to ensure that they are communicated. Public health advocacy shows throughout the news outlets’ articles as well as the journalists’ interviews with me. The journalists trust official health guidance is meant for the good of the community. This trust may stem from Filipino-American history in the United States healthcare system. The pandemic brought sudden high risks for the Filipino-Americans who work as nurses, doctors, and other healthcare professionals. Health journalism in Filipino- American media kept this in mind during the pandemic. The participants mostly spoke about the pandemic as though it was over, with three specifically using the phrase “during the pandemic.” This does not mean they believe the virus was destroyed or contained. Of those three, one said that the virus is “not going away anymore,” while another said that people have “stopped really looking into it.” This implies that they see the pandemic period as the time of responding to the disease rather than the disease itself. Writing about masking had journalistic importance when institutional authorities created policies about it. When those policies ended, the journalists no longer felt the need to continue writing about the related COVID-19 mitigation recommendations. Their public health advocacy had been connected to their ethnic advocacy during the pandemic, looking out for members of their ethnic community during the health crisis. The public health advocacy ebbed as the health crisis subsided; the ethnic advocacy continued. This reflects the news outlets’ primary purpose as Filipino-American ethnic media. This sample had a variety of experience levels among the participants. While the sample size is too small to make a generalizable statement, there seemed to be a correlation between the age of the journalist and their area of focus. The older journalists spoke more about community 27 health and protecting vulnerable populations, while the younger ones spoke more about community advocacy and justice. Summary The results of this study reaffirm that Filipino-American ethnic media journalists value the health and safety of their ethnic communities. As Communication Infrastructure Theory indicates, their papers form storytelling networks in the physical and digital environments of their audiences. The journalists communicate information to facilitate community health, and they determine what information to share based on institutional trust. They trusted government agencies for health information even amid politicization of health information. 28 CHAPTER 5: CONCLUSIONS This thesis explored how Filipino-American ethnic media journalists experienced health journalism during the first years of the COVID-19 pandemic. I researched how they reported on masking and other recommended health behaviors. I used both Communication Infrastructure Theory and Diffusion of Innovation Theory as theoretical lenses in this research in the context of Racial Activation Theory. This study reaffirms the use of social norms to encourage the adoption of health behaviors. Health messaging that reflects the audience’s cultural norms and values can be accepted into the storytelling network. The temporal implications of messaging should also be considered. While mask recommendations were adopted by the journalists into their networks, that adoption was temporary. Communication Infrastructure Theory explains the relationships between community members, community organizations, and ethnic media. These relationships provide the mechanics of communication as well as build the trust necessary for receivers to accept messages. The communication action context of their local communities changed during the early years of the COVID-19 pandemic. As part of meso-level storytelling networks, the journalists were keenly aware of how stay-at-home orders influenced their audiences. They searched for ways to maintain communication, leading to an increased adoption of communication technology. When the sociocultural context changed with political rhetoric, the journalists changed the tone of their stories to inform their readers while attempting to support their readers’ mental wellbeing. The journalists in this study described themselves and their papers as active participants in their communities. They said they had responsibilities to others’ health and wellbeing: 29 physical, mental, and social. The social responsibility described by bayanihan helps explain why the journalists reported encouragingly on recommended health behaviors. It also helps explain why the journalists said they accepted and followed the recommended health behaviors themselves. These are consistent with Diffusion of Innovation Theory. The international aspect of Filipino-American identity, particularly as shown in ethnic media, reflects the Designing for Diffusion Framework for Global Health Innovations model. Connections to immigrant communities allow health behaviors to be more easily shared across countries. By reporting on the countries of interest to the community, media reinforced masking as an effective behavior for preventing the spread of COVID-19. This study reaffirms the importance of timing in health messages. Because the journalists perceived mask recommendations as temporary, news coverage about masks faded out. Anti- mask protests did not cause the coverage to end; time did. This indicates that journalists take signals from public health authorities for determining how long a public health crisis lasts and should thus be kept salient in the audience’s minds. This may be a concern if the recommendations are meant to last longer than the crisis they address. Likewise, reporting on systemic issues like anti-Asian sentiment takes a longer time frame. The journalists experienced and/or heard about experiences of anti-Asian incidents in the midst of pandemic-related anti-Asian rhetoric. While the pandemic may have become less salient to the journalists, reporting on racism did not. This indicates that while the pandemic triggered racial activation during this time, the journalists did not perceive them to be limited to the same timeframe. The scope of this study is limited. The sample size and data collected were small. The results are tentative and exploratory. I identified two major limitations in this study. First, my 30 focus on Filipino-American ethnic media journalists may have been too narrow. Other researchers may wish to broaden their population of interest. Second, I had intended to use a reconstruction method of interviewing, but the time between the articles and my interviews meant that the journalists did not recall the process of writing specific articles. Future research exploring similar questions might focus on more recent articles to avoid this problem. This study may be a starting point for further research into ethnic media during health crises. Future research could explore Filipino-American reporting on the COVID-19 pandemic in more depth. It might also examine the effects of health journalism on the Filipino-American communities who read it. From a personal standpoint, I learned much about the process of conducting interview research. I can appreciate more how helpful it is to create detailed templates beforehand: here I had a list of questions for the interviews and a list of codes for the analysis. When it comes to sampling, I underestimated how difficult would be to contact people. In future research, I will have to develop my recruitment strategies more carefully. 31 BIBLIOGRAPHY Armenta, B. E., Lee, R. M., Pituc, S. T., Jung, K., Park, I. J. K., Soto, J. A., Kim, S.Y., & Schwartz, S. J. (2013). “Where are You From? 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