A Mixed-Method Examination of Primary Care Physician Message Strategies to Correct Patient-Held Health Misinformation: An Application of Goals-Plans-Action Theory

Abstract

Given the prevalence of health misinformation (i.e., inaccurate health messaging that lacks scientific evidence), there is a need for successful communication strategies to combat this detrimental health issue (Krishna & Thompson, 2021). Guided by goals-plans-action theory (Dillard, 1990), which explains the communicative process of creating and implementing influence messages, the purpose of this dissertation was to: (a) uncover primary care physician goals, plans, and action when correcting patient-held health misinformation and (b) experimentally test corrective influence messages for their effectiveness from the patient’s perspective. Two studies addressed these two purposes. In Study One, results of surveys of primary care physicians (N = 105) discovered significant, positive relationships between their primary goal (i.e., correction of health misinformation) and the secondary goals of identity and conversation management. Additionally, Study One results revealed five types of primary care physician strategic message plans during these conversations (i.e., vocalics, clarity, body positioning, listening behavior, relationship-building tone), and five themes for communicative action strategies that primary care physicians use when correcting patient-held health misinformation (i.e., scientific evidence-based explication, recommendations for evaluating health-related information and sources, emotional and/or relationship-building appeal, simple correction, disregard/judgment). Scenario-based corrective influence messaging was created based on communicative action themes from Study One (i.e., scientific evidence, evaluation recommendation, emotional appeal), checked for validity, and pilot tested. In Study Two, U.S. IX adults ages 18 years and older (N = 371) were asked to imagine they have found information online saying vaccines contain toxic ingredients and decide to bring this information up to their primary care physician, were randomly assigned to read a scenario from one of these three corrective influence messaging themes, and then reported their perceptions of the primary care physician. Results revealed no significant differences between scientific evidence and emotional appeal messages on key patient outcomes including perceived source credibility, patient satisfaction, intent to communicate with and share online health information to a primary care physician. Results of the two studies provide evidence for the applicability of goals-plans-action theory to the context of health misinformation and corrective influence messages, and yield recommendations for primary care physicians to implement when correcting health misinformation.