Background The success of behavioral interventions and policies designed to reduce the impact of the COVID-19 pandemic depends on how well individuals are informed about both the consequences of infection and the steps that should be taken to reduce the impact of the disease. Objective The aim of this study was to investigate associations between public knowledge about COVID-19, adherence to social distancing, and public trust in government information sources (eg, the US Centers for Disease Control and Prevention), private sources (eg, FOX and CNN), and social networks (eg, Facebook and Twitter) to inform future policies related to critical information distribution. Methods We conducted a cross-sectional survey (N=1243) between April 10 and 14, 2020. Data collection was stratified by US region and other demographics to ensure representativeness of the sample. Results Government information sources were the most trusted among the public. However, we observed trends in the data that suggested variations in trust by age and gender. White and older populations generally expressed higher trust in government sources, while non-White and younger populations expressed higher trust in private sources (eg, CNN) and social networks (eg, Twitter). Trust in government sources was positively associated with accurate knowledge about COVID-19 and adherence to social distancing. However, trust in private sources (eg, FOX and CNN) was negatively associated with knowledge about COVID-19. Similarly, trust in social networks (eg, Facebook and Twitter) was negatively associated with both knowledge and adherence to social distancing. Conclusions During pandemics such as the COVID-19 outbreak, policy makers should carefully consider the quality of information disseminated through private sources and social networks. Furthermore, when disseminating urgent health information, a variety of information sources should be used to ensure that diverse populations have timely access to critical knowledge.

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BACKGROUND Success of behavioral interventions and policies designed to reduce the impact of COVID-19 depends on how well individuals are informed about both the consequences of infection and the steps that are needed to reduce the impact of the virus. OBJECTIVE To inform future policies related to critical information distribution, we investigated associations between public knowledge about COVID-19, adherence to social distancing, and public trust in government information sources (e.g. CDC), private sources (e.g. FOX, CNN), and social networks (e.g. Facebook, Twitter). METHODS We conducted a cross-national survey (n=1243) between April 10th –14th, 2020. Data collection was stratified by US region and other demographics to ensure representativeness of the sample. RESULTS Government information sources were the most trusted among the public. However, we observed a trend in the data that suggested variations in trust by age and gender. White and older populations generally expressed higher trust in government sources, while non-white and younger populations expressed higher trust in private sources (e.g. CNN) and social networks (e.g. Twitter). Trust in government sources was positively associated with accurate knowledge about COVID-19 and adherence to social distancing. Whereas, trust in private sources (e.g. FOX, CNN) was negatively associated with knowledge about COVID-19. Similarly, trust in social networks (e.g. Facebook and Twitter) was negatively associated with both knowledge and adherence to social distancing. CONCLUSIONS During pandemics, like the COVID-19 outbreak, policymakers should carefully consider the quality of information disseminated through private sources and social networks. Furthermore, when disseminating urgent health information, a variety of information sources should be utilized to ensure that diverse populations have timely access to critical knowledge. CLINICALTRIAL