Adolescent girls’ perceptions of the COVID-19 infodemic in Sierra Leone: a qualitative study in urban, peri-urban and rural Sierra Leone

Abstract

OBJECTIVE: This study aimed to identify the primary sources of COVID-19 health information for adolescent girls in Sierra Leone and evaluate their perceived trustworthiness and influence on their behaviour. DESIGN: Using a convenience sampling strategy grounded in the social cognitive theory, the study explored adolescents' navigation and appraisal of health information sources, their understanding of COVID-19, and the impact of societal and observational influences on their health beliefs and actions. Data analysis involved thematic analysis using NVivo V.12 software, focusing on patterns within responses related to observational learning, trusted sources and behavioural outcomes. SETTING: Sierra Leone, July 2020. PARTICIPANTS: 16 focus group discussions were conducted among 86 adolescents (6-8 per group) aged 15-19 years in Sierra Leone. OUTCOME MEASURE: Primary sources of COVID-19 information. RESULTS: Adolescent girls identified a diverse range of health information sources, including schools, social media, health workers and radio, with notable differences in trust and preference based on geographical and social contexts. A noteworthy finding was the significant trust placed in health workers, marking a stark contrast to fear and mistrust during the Ebola emergency only 5 years previously. This renewed trust in health professionals emerged as a critical factor influencing adolescents' health behaviours and acceptance of COVID-19 preventive measures. CONCLUSION: This study underscores the complexity of navigating health information among adolescent girls during the COVID-19 pandemic. It highlights the importance of tailored public health messaging that accounts for local cultural contexts, addresses misconceptions and builds on trusted information sources to foster effective health behaviours. Future interventions could prioritise enhancing educational resources, leveraging trusted community figures, and ensuring that health communication is scientifically accurate and culturally sensitive.