Susceptibility to misinformation about COVID-19 around the world

BackgroundAmid the COVID-19 pandemic, social media have influenced the circulation of health information. Public health agencies often use Twitter to disseminate and amplify the propagation of such information. Still, exposure to local government–endorsed COVID-19 public health information does not make one immune to believing misinformation. Moreover, not all health information on Twitter is accurate, and some users may believe misinformation and disinformation just as much as those who endorse more accurate information. This situation is complicated, given that elected officials may pursue a political agenda of re-election by downplaying the need for COVID-19 restrictions. The politically polarized nature of information and misinformation on social media in the United States has fueled a COVID-19 infodemic. Because pre-existing political beliefs can both facilitate and hinder persuasion, Twitter users’ belief in COVID-19 misinformation is likely a function of their goal inferences about their local government agencies’ motives for addressing the COVID-19 pandemic.ObjectiveWe shed light on the cognitive processes of goal understanding that underlie the relationship between partisanship and belief in health misinformation. We investigate how the valence of Twitter users’ goal inferences of local governments’ COVID-19 efforts predicts their belief in COVID-19 misinformation as a function of their political party affiliation.MethodsWe conducted a web-based cross-sectional survey of US Twitter users who followed their state’s official Department of Public Health Twitter account (n=258) between August 10 and December 23, 2020. Inferences about local governments’ goals, demographics, and belief in COVID-19 misinformation were measured. State political affiliation was controlled.ResultsParticipants from all 50 states were included in the sample. An interaction emerged between political party affiliation and goal inference valence for belief in COVID-19 misinformation (∆R2=0.04; F8,249=4.78; P<.001); positive goal inference valence predicted increased belief in COVID-19 misinformation among Republicans (β=.47; t249=2.59; P=.01) but not among Democrats (β=.07; t249=0.84; P=.40).ConclusionsOur results reveal that favorable inferences about local governments’ COVID-19 efforts can accelerate belief in misinformation among Republican-identifying constituents. In other words, accurate COVID-19 transmission knowledge is a function of constituents' sentiment toward politicians rather than science, which has significant implications on public health efforts for minimizing the spread of the disease, as convincing misinformed constituents to practice safety measures might be a political issue just as much as it is a health one. Our work suggests that goal understanding processes matter for misinformation about COVID-19 among Republicans. Those responsible for future COVID-19 public health messaging aimed at increasing belief in valid information about COVID-19 should recognize the need to test persuasive appeals that address partisans’ pre-existing political views in order to prevent individuals’ goal inferences from interfering with public health messaging.

Misinformation related to COVID-19 is a threat to public health. The present study examined the potential for deliberative cognitive styles such as actively open-minded thinking and need for evidence in deterring belief in misinformation and promoting belief in true information related to COVID-19. In addition, regarding how responses to the pandemic have been politicized, the role of political orientation and motivated reasoning were also examined. We conducted a survey in South Korea (N = 1466) during May 2020. Participants answered measures related to demographics, open-minded thinking, need for evidence, and accuracy perceptions of COVID-19 misinformation and true information items. Multi-level analyses of the survey data found that while motivated reasoning was present, deliberative cognitive styles (actively open-minded thinking and need for evidence) decreased belief in misinformation without intensifying motivated reasoning tendencies. Findings also showed a political asymmetry where conservatives detected COVID-19 misinformation at a lesser rate. Overall, results suggest that health communication related to COVID-19 misinformation should pay attention to conservative populations. Results also imply that interventions that activate deliberative cognitive styles hold promise in reducing belief in COVID-19 misinformation.

BackgroundSeasonal malaria chemoprevention (SMC) using sulfadoxine-pyrimethamine and amodiaquine is an efficacious intervention for protection of children against Plasmodium falciparum malaria during the rainy season. In response to the global COVID-19 pandemic, Malaria Consortium adapted its SMC delivery model to ensure safety of distributors, data collectors and beneficiaries. We conducted a SMC monitoring survey in July 2020 in the states of Bauchi, Jigawa, Kano, Katsina, Sokoto and Yobe, with questions on COVID-19 prevention behaviours and symptoms, and belief in misinformation. We investigated the associations between receipt of information on COVID-19 by different sources, including from SMC distributors, and these three outcomes using logistic generalised estimating equations. We also considered moderation of effectiveness of message delivery by SMC distributors and adherence to use of face coverings.ResultsWe obtained a representative sample of 40,157 caregivers of eligible children aged 3–59 months, of which 36,914 (91.92%) reported knowledge of COVID-19. The weighted proportions of respondents who correctly identified COVID-19 prevention behaviours and symptoms, and who reported belief in COVID-19 misinformation, were 80.52% (95% confidence interval [95% CI] 80.02–81.00), 81.72% (95% CI 81.23–82.20) and 22.90% (95% CI 22.24–23.57). Receipt of information on COVID-19 from SMC distributors during the campaign was significantly associated with higher odds of caregiver knowledge of COVID-19 prevention behaviours (odds ratio [OR] 1.78, 95% CI 1.64–1.94, p < 0.001) and symptoms (OR 1.74, 95% CI 1.59–1.90, p < 0.001) and lower odds of belief in COVID-19 misinformation (OR 0.92, 95% CI 0.85–1.00, p = 0.038). The associations between message delivery by SMC distributors and the three outcomes were moderated by their adherence to face covering use. Receipt of information by other sources used to deliver government public health messages, including radio and health facility workers, was also associated with knowledge of COVID-19.ConclusionsMalaria Consortium’s SMC programme was successfully adapted in the context of COVID-19 and was a conduit for high-quality public health messages. Standard SMC monitoring and evaluation activities can be adapted to gather evidence on emerging public health issues such as the global COVID-19 pandemic.

Science has established the human-caused nature of climate change, yet the prevalence of climate-related misinformation persists, undermining public understanding and impeding collective action. Strikingly, existing research on belief in misinformation about climate change has disproportionately focused on WEIRD (Western, Educated, Industrialized, Rich, and Democratic) countries. To move beyond this, our online survey (N = 8541) includes high-income countries in North America (US), Western Europe (France, Germany, UK) and East Asia (Japan), as well as an upper-middle income country in South America (Brazil) and lower-middle income countries in South Asia (India and Pakistan). By examining the interplay of news media usage, information sources, and trust in these sources, we advance our understanding of how these factors influence belief in climate change-related misinformation in diverse socio-cultural contexts. Across countries, we found that the strongest determinants of belief in misinformation about climate change were identifying as right-wing (compared with left-wing), consuming less offline news, having less trust in scientists, environmental activists, as well as international organizations, and having more trust in politicians, celebrities, and energy companies. Overall, trust in sources of information about climate change and demographic variables were much stronger predictors of belief in misinformation about climate change than reported news consumption (online, offline or on social media). These findings suggest that trust is key to understanding belief in false information about climate change.

BackgroundTrust in science meaningfully contributes to our understanding of people’s belief in misinformation and their intentions to take actions to prevent COVID-19. However, no experimental research has sought to intervene on this variable to develop a scalable response to the COVID-19 infodemic.ObjectiveOur study examined whether brief exposure to an infographic about the scientific process might increase trust in science and thereby affect belief in misinformation and intention to take preventive actions for COVID-19.MethodsThis two-arm, parallel-group, randomized controlled trial aimed to recruit a US representative sample of 1000 adults by age, race/ethnicity, and gender using the Prolific platform. Participants were randomly assigned to view either an intervention infographic about the scientific process or a control infographic. The intervention infographic was designed through a separate pilot study. Primary outcomes were trust in science, COVID-19 narrative belief profile, and COVID-19 preventive behavioral intentions. We also collected 12 covariates and incorporated them into all analyses. All outcomes were collected using web-based assessment.ResultsFrom January 22, 2021 to January 24, 2021, 1017 participants completed the study. The intervention slightly improved trust in science (difference-in-difference 0.03, SE 0.01, t1000=2.16, P=.031). No direct intervention effect was observed on belief profile membership, but there was some evidence of an indirect intervention effect mediated by trust in science (adjusted odds ratio 1.06, SE 0.03, 95% CI 1.00-1.12, z=2.01, P=.045) on membership in the “scientific” profile compared with the others. No direct nor indirect effects on preventive behaviors were observed.ConclusionsBriefly viewing an infographic about science appeared to cause a small aggregate increase in trust in science, which may have, in turn, reduced the believability of COVID-19 misinformation. The effect sizes were small but commensurate with our 60-second, highly scalable intervention approach. Researchers should study the potential for truthful messaging about how science works to serve as misinformation inoculation and test how best to do so.Trial RegistrationNCT04557241; https://clinicaltrials.gov/ct2/show/NCT04557241International Registered Report Identifier (IRRID)RR2-10.2196/24383

This study quantitatively examines whether health literacy can reduce belief in COVID-19 misinformation and conspiracy theories. Conducting path and cluster analyses on survey data collected from 1,488 adults in Japan in 2021, we found that while health literacy reduces people’s belief about COVID-19 and vaccination misinformation, it has no direct effect on their belief in COVID-19 conspiracy theories. That said, the results also highlighted the importance of health literacy. It is found that even though high health literacy does not guarantee a low degree of conspiracy beliefs, low health literacy is associated with high susceptibility to both misinformation and conspiracy theories. Moreover, people who relied more on social media than mass media for COVID-19 news and reported on having been more severely affected by the pandemic were found to be more likely to have lower health literacy and higher belief in misinformation and conspiracy theories. Based on the findings, we discussed ways to enhance health literacy research and promotion in Japan.

Sociopolitical and psychological correlates of COVID-19 vaccine hesitancy in the United States during summer 2021

Does the news media exacerbate or reduce misinformation problems? Although some news media deliberately try to counter misinformation, it has been suggested that they might also inadvertently, and sometimes purposefully, amplify it. We conducted a two-wave panel survey in Brazil, India, and the UK ( N = 4732) to investigate the effect of news and digital platform use on awareness of and belief in COVID-19 misinformation over time (January to February 2022). We find little support for the idea that the news exacerbates misinformation problems. News use broadened people's awareness of false claims but did not increase belief in false claims—in some cases, news use actually weakened false belief acquisition, depending on access mode (online or offline) and outlet type. In line with previous research, we also find that news use strengthens political knowledge gain over time, again depending on outlets used. The effect of digital platforms was inconsistent across countries, and in most cases not significant—though some, like Twitter, were associated with positive outcomes while others were associated with negative outcomes. Overall, our findings challenge the notion that news media, by reporting on false and misleading claims, ultimately leave the public more misinformed, and support the idea that news helps people become more informed and, in some cases, more resilient to misinformation.

This study explores the role of the news-finds-me (NFM) perception—the belief that people can be well-informed without actively seeking news due to their social networks—in fostering social media users’ inaccurate beliefs about COVID-19. Findings from a US national survey ( N = 1003) suggest that NFM perception is positively associated with belief in COVID-19 misinformation and mediates the positive relationship between social media use and false beliefs when NFM is measured as a single-dimensional construct. However, the sub-dimensions of NFM have distinct implications: The reliance on peers and not seeking but feeling informed dimensions work in the same manner as when NFM is treated as a single-dimensional construct, whereas reliance on algorithmic news negatively predicts belief in misinformation and negatively mediates the aforementioned relationship. We also found the mediating role of exposure to misinformation in the relationship between social media use and false beliefs. Implications from these findings are discussed.

Wide-spread misinformation about the COVID-19 pandemic has presented challenges for communicating public health recommendations. Should campaigns to promote protective behaviors focus on debunking misinformation or targeting behavior-specific beliefs? To address this question, we examine whether belief in COVID-19 misinformation is directly associated with two behaviors (face mask wearing and social distancing), and whether behavior-specific beliefs can account for this association and better predict behavior, consistent with behavior-change theory. We conducted a nationally representative two-wave survey of U.S. adults from 5/26/20-6/12/20 (n = 1074) and 7/15/20-7/21//20 (n = 889; follow-up response 83%). Scales were developed and validated for COVID-19 related misinformation beliefs, social distancing and face mask wearing, and beliefs about the consequences of both behaviors. Cross-lagged panel linear regression models assessed relationships among the variables. While belief in misinformation was negatively associated with both face mask wearing (B = −.27, SE =.06) and social-distancing behaviors (B = −.46, SE =.08) measured at the same time, misinformation did not predict concurrent or lagged behavior when the behavior-specific beliefs were incorporated in the models. Beliefs about behavioral outcomes accounted for face mask wearing and social distancing, both cross-sectionally (B =.43, SE =.05; B =.63, SE =.09) and lagged over time (B =.20, SE = 04; B =.30, SE =.08). In conclusion, belief in COVID-19-related misinformation is less relevant to protective behaviors, but beliefs about the consequences of these behaviors are important predictors. With regard to misinformation, we recommend health campaigns aimed at promoting protective behaviors emphasize the benefits of these behaviors, rather than debunking unrelated false claims.

BackgroundOnline misinformation proliferation during the COVID-19 pandemic has become a major public health concern.ObjectiveWe aimed to assess the prevalence of COVID-19 misinformation exposure and beliefs, associated factors including psychological distress with misinformation exposure, and the associations between COVID-19 knowledge and number of preventive behaviors.MethodsA cross-sectional online survey was conducted with 1049 South Korean adults in April 2020. Respondents were asked about receiving COVID-19 misinformation using 12 items identified by the World Health Organization. Logistic regression was used to compute adjusted odds ratios (aORs) for the association of receiving misinformation with sociodemographic characteristics, source of information, COVID-19 misinformation belief, and psychological distress, as well as the associations of COVID-19 misinformation belief with COVID-19 knowledge and the number of COVID-19 preventive behaviors among those who received the misinformation. All data were weighted according to the Korea census data in 2018.ResultsOverall, 67.78% (n=711) of respondents reported exposure to at least one COVID-19 misinformation item. Misinformation exposure was associated with younger age, higher education levels, and lower income. Sources of information associated with misinformation exposure were social networking services (aOR 1.67, 95% CI 1.20-2.32) and instant messaging (aOR 1.79, 1.27-2.51). Misinformation exposure was also associated with psychological distress including anxiety (aOR 1.80, 1.24-2.61), depressive (aOR 1.47, 1.09-2.00), and posttraumatic stress disorder symptoms (aOR 1.97, 1.42-2.73), as well as misinformation belief (aOR 7.33, 5.17-10.38). Misinformation belief was associated with poorer COVID-19 knowledge (high: aOR 0.62, 0.45-0.84) and fewer preventive behaviors (≥7 behaviors: aOR 0.54, 0.39-0.74).ConclusionsCOVID-19 misinformation exposure was associated with misinformation belief, while misinformation belief was associated with fewer preventive behaviors. Given the potential of misinformation to undermine global efforts in COVID-19 disease control, up-to-date public health strategies are required to counter the proliferation of misinformation.

Trust in science and belief in misinformation mediate the effects of political orientation on vaccine hesitancy and intention to be vaccinated

Background Throughout the ongoing COVID-19 pandemic debunking misinformation has been one of the most employed strategies used to address vaccine hesitancy. We investigated whether – and for whom – debunking is effective or even counterproductive in decreasing misinformation belief and vaccination hesitancy. Method We conducted a randomized controlled trial (N = 588) utilizing a real-world debunking campaign from the German Ministry of Health. We considered the condition (debunking vs. control) as between-subjects factor, assessed misinformation belief (pretest vs. posttest) as a repeated-measures factor and vaccination intention as a dependent variable. Preregistered subgroup analyses were conducted for different levels of a priori misinformation belief and general vaccination confidence. Results The analyses revealed differential effects on misinformation belief and vaccination intention in participants with low, medium, and high a priori belief: A debunking effect on misinformation belief (dRM = –0.80) was only found in participants with a medium a priori belief and did not extend to these participants’ vaccination intentions. Among participants with a high a priori misinformation belief, explorative analysis revealed a small unintended backfiring effect on vaccination intentions (ηp 2 = 0.03). Conclusions Our findings suggest that debunking is an effective communication strategy to address moderate levels of misinformation beliefs, but it does not constitute a one-fits-all strategy to reduce vaccination hesitancy among the general public. Although countering misinformation should certainly be an integral part of public health communication, additional initiatives, which address individual concerns with targeted and authentic communication, should be taken to enhance the impact on hesitant populations and avoid backfiring effects.

Misinformation about COVID-19 vaccines has hampered their uptake worldwide. In Ghana, a belief that COVID-19 vaccines affect fertility is prevalent and difficult to counter. UNICEF Ghana co-produced a context-driven, behavioral science-based audio drama (‘A shot of love’) that aimed to debunk this misinformation narrative. In a randomized controlled trial, 13,000 young adults who had previously interacted with UNICEF’s Agoo platform were randomized to either control (audio about nutrition) or intervention (audio drama debunking the COVID-19 misinformation). We found that the intervention had a strong protective effect against belief in misinformation, both directly after listening to the audio drama (adjusted Odds Ratio (aOR) 0.45, 95% Confidence Interval (CI) 0.34–0.59) as well as at the one-month follow-up (aOR 0.66, 95% CI 0.49–0.91). Similarly, the intervention had a strong effect on perceived safety of the COVID-19 vaccines directly after listening to the audio drama (aOR 1.56, 95% CI 1.22-2.00) and at one-month follow-up (aOR 1.53, 95% CI 1.13–2.07). Overall, our behavioral science-based, context-driven audio drama was effective in reducing the strength of belief in COVID-19 vaccine misinformation and increasing the perceived safety of the vaccines in Ghana.

Conspiracy Theories, Mistrust Take Root During Pandemic