Health Misinformation Research Articles

Development and Validation of COVID-19 Vaccine Messaging Materials for Latinx Communities

With pervasive health misinformation and mistrust, many of those at greatest risk from COVID-19 have demonstrated lower vaccine acceptance. In Chicago, IL, surveillance data has revealed lower rates of vaccine uptake among Black and Latinx individuals compared with others. We partnered with two local federally qualified health centers (FQHCs) to develop and implement language-concordant, low literacy patient education materials to promote COVID-19 vaccine knowledge, acceptance, and uptake. Our multi-phase study included: 1) iterative content generation and refinement by health literacy experts, health center providers and staff, and community-dwelling adults; and 2) materials testing via a two-arm randomized experiment among adults from Latinx communities in the Chicagoland area. Results indicate that our English and Spanish-language COVID-19 Fact Sheets increase knowledge about COVID-19 vaccination. These materials are publicly available and can be used by health centers or community organizations to promote COVID-19 vaccination among diverse populations.

Ketika Fakta Bukanlah Kebenaran: Peran Media Daring dalam Amplifikasi Misinformasi Kesehatan di Era Pandemi Covid-19

During the Covid-19 epidemic, people must not only escape getting infected with the virus, but also avoid being targeted by hoaxes. In cyberspace, there are several topics of misinformation ranging from conspiracy theories to claims of finding anti-corona medications. Various studies have discovered that during a pandemic, social media is the mechanism through which health misinformation begins and spreads. However, there is a lack of data on misinformation disseminated by other media, particularly verified media. This study intends to bridge a research gap by investigating more into how claims of traditional medicine healing Covid-19 are publicized by Indonesian online news outlets. This study did a content analysis of 14 media articles from various online media about anti-corona herbal remedies affiliated to the 'Covid-19 Herbal Research Team for the Nation.' The study's findings suggest that in reporting on anti-corona medications, the majority of the media have abandoned the discipline of verification in the news production process. The media has amplified the lies of the 'Covid-19 Herbal Research Team for the Nation' through misleading headlines and reports that only feature sole claims.

Predicting Fact-Checking Health Information Before Sharing Among People with Different Levels of Altruism: Based on the Influence of Presumed Media Influence.

Pervasive health misinformation on social media affects people's health. Fact-checking health information before it is shared is an altruistic behavior that effectively addresses health misinformation on social media. Based on the influence of presumed media influence (IPMI), this study serves two purposes: The first is to investigate factors that influence social media users' decisions to fact-check health information before sharing it in accordance with the IPMI model. The second is to explore different predictive powers of the IPMI model for individuals with different levels of altruism. This study conducted a questionnaire survey of 1045 Chinese adults. Participants were divided into either a low-altruism group (n = 545) or a high-altruism group (n = 500) at the median value of altruism. A multigroup analysis was conducted with R Lavaan package (Version 0.6-15). All of the hypotheses were supported, which confirms the applicability of the IPMI model in the context of fact-checking health information on social media before sharing. Notably, the IPMI model yielded different results for the low- and high-altruism groups. This study confirmed the IPMI model can be employed in the context of fact-checking health information. Paying attention to health misinformation can indirectly affect an individual's intention to fact-check health information before they share it on social media. Furthermore, this study demonstrated the IPMI model's varying predictive powers for individuals with different altruism levels and recommended specific strategies health-promotion officials can take to encourage others to fact-check health information.

Combating Online Health Misinformation: A Professional’s Guide to Helping the Public (book review)

Combating Online Health Misinformation: A Professional’s Guide to Helping the Public (book review)

VIRAL HEALTH MISINFORMATION FROM GEOCITIES TO COVID-19

Although often discussed in the public discourse as a phenomenon newly exacerbated by social media, the use of the Internet to spread health-related misinformation is as old as the Internet itself. Techniques, networks, and narratives from prior novel health outbreaks such as HIV or Ebola continue to circulate and are repurposed in the current COVID-19 pandemic. We examine and compare two case studies of health misinformation — HIV mis/disinformation in from the mid-1990s to early 2000s circulating in GeoCities and the role of official COVID-19 Dashboards in present-day COVID-19 mis/disinformation. This contributes to our understanding of current and historical health misinformation as well as the connections between them.

Public Figure Vaccination Rhetoric and Vaccine Hesitancy: Retrospective Twitter Analysis.

Social media has emerged as a critical mass communication tool, with both health information and misinformation now spread widely on the web. Prior to the COVID-19 pandemic, some public figures promulgated anti-vaccine attitudes, which spread widely on social media platforms. Although anti-vaccine sentiment has pervaded social media throughout the COVID-19 pandemic, it is unclear to what extent interest in public figures is generating anti-vaccine discourse. We examined Twitter messages that included anti-vaccination hashtags and mentions of public figures to assess the connection between interest in these individuals and the possible spread of anti-vaccine messages. We used a data set of COVID-19-related Twitter posts collected from the public streaming application programming interface from March to October 2020 and filtered it for anti-vaccination hashtags "antivaxxing," "antivaxx," "antivaxxers," "antivax," "anti-vaxxer," "discredit," "undermine," "confidence," and "immune." Next, we applied the Biterm Topic model (BTM) to output topic clusters associated with the entire corpus. Topic clusters were manually screened by examining the top 10 posts most highly correlated in each of the 20 clusters, from which we identified 5 clusters most relevant to public figures and vaccination attitudes. We extracted all messages from these clusters and conducted inductive content analysis to characterize the discourse. Our keyword search yielded 118,971 Twitter posts after duplicates were removed, and subsequently, we applied BTM to parse these data into 20 clusters. After removing retweets, we manually screened the top 10 tweets associated with each cluster (200 messages) to identify clusters associated with public figures. Extraction of these clusters yielded 768 posts for inductive analysis. Most messages were either pro-vaccination (n=329, 43%) or neutral about vaccination (n=425, 55%), with only 2% (14/768) including anti-vaccination messages. Three main themes emerged: (1) anti-vaccination accusation, in which the message accused the public figure of holding anti-vaccination beliefs; (2) using "anti-vax" as an epithet; and (3) stating or implying the negative public health impact of anti-vaccination discourse. Most discussions surrounding public figures in common hashtags labelled as "anti-vax" did not reflect anti-vaccination beliefs. We observed that public figures with known anti-vaccination beliefs face scorn and ridicule on Twitter. Accusing public figures of anti-vaccination attitudes is a means of insulting and discrediting the public figure rather than discrediting vaccines. The majority of posts in our sample condemned public figures expressing anti-vax beliefs by undermining their influence, insulting them, or expressing concerns over public health ramifications. This points to a complex information ecosystem, where anti-vax sentiment may not reside in common anti-vax-related keywords or hashtags, necessitating further assessment of the influence that public figures have on this discourse.

The Effect of Repetition on the Perceived Truth of Tobacco-Related Health Misinformation Among U.S. Adults

As concerns about the effects of health misinformation rise, understanding why misbeliefs are accepted is increasingly important. People believe repeated statements more than novel statements, an effect known as truth by repetition, however this has not been examined in the context of tobacco information. Misbeliefs about tobacco are rampant and novel facts about tobacco are viewed as less believable. This paper examines how repetition of true and false tobacco statements affects truth perceptions. We recruited an online sample of 1,436 U.S. adults in May 2021. In an exposure phase, each participant rated their interest in 30 randomly selected statements about tobacco products and general knowledge trivia, half of them true and half false. The study had a two (tobacco product) by two (familiarity of statement claim) between-subjects design and a two (statement truth) by two (statement repetition) within-subjects design. During the testing phase participants rated the truthfulness of 24 repeated statements and 24 unseen statements. Repetition of true and false tobacco statements increased their subjective truth (diff=.20, p < .001), and the effect was larger for false claims compared to true claims. This underscores the importance of strategies to inoculate people against misinformation and calls for interventions that can stop the repetition of newly generated false claims.

How People Process Different Types of Health Misinformation: Roles of Content Falsity and Evidence Type

ABSTRACT Emerging communication technologies have seen the proliferation of misleading claims, untruthful narratives, and conspiracies. To understand how people perceive and act on different types of misinformation, this study examines how health misinformation varying in falsity (fabrication versus misuse) and evidence type (statistical versus narrative) affects sharing and verification intentions. Using COVID-19 vaccines as cases, the results from an online experiment showed that misused misinformation was perceived as less false than fabricated misinformation and resulted in higher sharing intentions for the issue of vaccine efficacy. Misinformation with narrative evidence, as compared to that with statistical evidence, was perceived as less false and led to lower verification intentions. These findings can be explained by psychological processes such as counterarguing and narrative engagement. Our results can help practitioners develop dedicated misinformation literacy programs.

How Should State Licensing and Credentialing Boards Respond When Government Clinicians Spread False or Misleading Health Information?

The spread of health misinformation by health care professionals who also hold government positions represents a long-standing problem that intensified during the COVID-19 pandemic. This article describes this problem and considers legal and other response strategies. State licensing and credentialing boards must use their authorities to discipline clinicians who spread misinformation and to reinforce the nature and scope of professional and ethical obligations of government and nongovernment clinicians. Individual clinicians must also play an important role by actively and vigorously correcting misinformation disseminated by other clinicians.

One Year of COVID-19 Vaccine Misinformation on Twitter: Longitudinal Study.

Vaccinations play a critical role in mitigating the impact of COVID-19 and other diseases. Past research has linked misinformation to increased hesitancy and lower vaccination rates. Gaps remain in our knowledge about the main drivers of vaccine misinformation on social media and effective ways to intervene. Our longitudinal study had two primary objectives: (1) to investigate the patterns of prevalence and contagion of COVID-19 vaccine misinformation on Twitter in 2021, and (2) to identify the main spreaders of vaccine misinformation. Given our initial results, we further considered the likely drivers of misinformation and its spread, providing insights for potential interventions. We collected almost 300 million English-language tweets related to COVID-19 vaccines using a list of over 80 relevant keywords over a period of 12 months. We then extracted and labeled news articles at the source level based on third-party lists of low-credibility and mainstream news sources, and measured the prevalence of different kinds of information. We also considered suspicious YouTube videos shared on Twitter. We focused our analysis of vaccine misinformation spreaders on verified and automated Twitter accounts. Our findings showed a relatively low prevalence of low-credibility information compared to the entirety of mainstream news. However, the most popular low-credibility sources had reshare volumes comparable to those of many mainstream sources, and had larger volumes than those of authoritative sources such as the US Centers for Disease Control and Prevention and the World Health Organization. Throughout the year, we observed an increasing trend in the prevalence of low-credibility news about vaccines. We also observed a considerable amount of suspicious YouTube videos shared on Twitter. Tweets by a small group of approximately 800 "superspreaders" verified by Twitter accounted for approximately 35% of all reshares of misinformation on an average day, with the top superspreader (@RobertKennedyJr) responsible for over 13% of retweets. Finally, low-credibility news and suspicious YouTube videos were more likely to be shared by automated accounts. The wide spread of misinformation around COVID-19 vaccines on Twitter during 2021 shows that there was an audience for this type of content. Our findings are also consistent with the hypothesis that superspreaders are driven by financial incentives that allow them to profit from health misinformation. Despite high-profile cases of deplatformed misinformation superspreaders, our results show that in 2021, a few individuals still played an outsized role in the spread of low-credibility vaccine content. As a result, social media moderation efforts would be better served by focusing on reducing the online visibility of repeat spreaders of harmful content, especially during public health crises.

Recognising and addressing health misinformation in nursing practice

Recognising and addressing health misinformation in nursing practice

Entertaining information: Third-party influencers’ role in COVID-safety health communication

This paper discusses findings from a commissioned evaluation of an Australian government COVID-19 health campaign that utilised third-party influencers to increase the reach of health communication messages among culturally and linguistically diverse young people. Although the campaign was successful, interviews with select influencers and target audience members indicated that the ‘serious’ tone of the health messaging was less effective and less likely to be shared and that messages should be more ‘entertaining’. Analyses of data indicated three themes providing insights into how future campaigns may benefit from a focus that draws together health information and entertainment using models already constructed in the entertainment–education field: (1) Entertaining health messages have a stronger fit with influencers who are known for their entertainment value; (2) Entertaining messages are more memorable and more likely to be shared; (3) A balance between entertainment and the signifiers of trust and credibility such as government health authority logos overcomes trust issues in the context of current health disinformation and misinformation.

How School Libraries Can Promote Health Literacy in Challenging Times

Health literacy skills are needed to source, evaluate, and comprehend health information and services in order to make appropriate and informed health decisions. Given that an individual’s health outcomes are positively influenced by their level of health literacy, schools are increasingly committed to fostering health literacy in their students. Young people may face many health literacy challenges exacerbated by the global pandemic and the burgeoning array of questionable health information disseminated through social media. As information and digital literacy experts, school library professionals can draw upon their existing skillset and further extend their skills in order to play a key role in developing students’ health literacy, supporting their capacity to reject health misinformation and be discerning consumers of health information from a wide range of sources.

"Health Politicization and Misinformation have Increased the Damage of the Covid 19 Pandemic"

"Health Politicization and Misinformation have Increased the Damage of the Covid 19 Pandemic"

The Role of Graduate Medical Education in the Fight Against Health Misinformation.

The Role of Graduate Medical Education in the Fight Against Health Misinformation.

Health misinformation and freedom of expression: considerations for policymakers.

Health misinformation, most visibly following the COVID-19 infodemic, is an urgent threat that hinders the success of public health policies. It likely contributed, and will continue to contribute, to avoidable deaths. Policymakers around the world are being pushed to tackle this problem. Legislative acts have been rolled out or announced in many countries and at the European Union level. The goal of this paper is not to review particular legislative initiatives, or to assess the impact and efficacy of measures implemented by digital intermediaries, but to reflect on the high constitutional and ethical stakes involved in tackling health misinformation through speech regulation. Our findings suggest that solutions focused on regulating speech are likely to encounter significant constraints, as policymakers grasp with the limitations imposed by freedom of expression and ethical considerations. Solutions focused on empowering individuals - such as media literacy initiatives, fact-checking or credibility labels - are one way to avoid such hurdles.

Social Media as a Conduit for Spreading Misinformation: An Examination of Antivaccination Messages in the Wake of the 2019 Washington Measles Outbreak

Public health experts have studied global pandemics long before the COVID-19 outbreak of 2020. Since the worldwide spread of HIV, SARS, H1N1, and Ebola among others, scholars have focused on identifying best practices for risk mitigation and reaching disparate publics to engage in appropriate risk mitigation behaviors. The 2019 measles outbreak in Washington, USA flourished in large part due to the viral spread of misinformation on social networking platforms. Due to the intended openness of these platforms, antivaccination messaging became prominent, and the U.S. among other countries to have eradicated measles saw a number of outbreaks. In the U.S. in 2019, many of these occurred in Washington state. These outbreaks served as an impetus for social media platforms to reconsider their role in spreading health misinformation and its contribution to real-world danger. This analysis considers open media ethics to understand social media platforms’ initial decisions to allow vaccine misinformation and the role of communication scholars and practitioners have in understanding, and acting on misinformation. Using a case study approach, this article examines online discourse about the measles, mumps, and rubella vaccine, policy measures related to vaccine exemption, and social media organization formal responses in 2019 directly related to the increase in U.S. measles outbreaks. Using an open media ethics framework, findings from this study illustrate the ways in which these organizations initially intended to have an open platform for health-related discussions. Further analysis demonstrates that these organizations focused on existing terms of use to put in place protective measures that would prevent the further spread of this mis- and disinformation. However, conclusions drawn illustrate that placing the onus on social media organizations alone is insufficient to prevent outbreaks such as this to occur, and as the COVID-19 pandemic began the following year, the implications of this study continue to pose questions about social media misinformation management. Keywords: media ethics; misinformation; social networks; user-generated content; vaccine hesitancy

Piloting a COVID-19 vaccine chatbot with young adults and health workers in the U.S. to validate usability, credibility, and intention to use.

The COVID-19 pandemic raised novel challenges in communicating reliable, continually changing health information to a broad and sometimes skeptical public, particularly around COVID-19 vaccines, which despite being comprehensively studied were the subject of viral misinformation. Chatbots are a promising technology to reach and engage populations during the pandemic. To inform and communicate effectively with users, chatbots must be highly usable and credible. We sought to understand how young adults and health workers in the U.S. assessed the usability and credibility of a web-based chatbot called Vira, created by the Johns Hopkins Bloomberg School of Public Health and IBM Research using natural language processing technology. Using a mixed-method approach, we sought to rapidly improve Vira's user experience to support vaccine decision-making during the peak of the COVID-19 pandemic. We recruited racially and ethnically diverse young people and health workers, with both groups from urban areas of the U.S. We used the validated Chatbot Usability Questionnaire (CUQ) to understand the tool's navigation, precision, and persona. We also conducted 11 interviews with health workers and young people to understand the user experience, whether they perceived the chatbot as confidential and trustworthy, and how they would use the chatbot. We coded and categorized emerging themes to understand the determining factors for participants' assessment of chatbot usability and credibility. Fifty-eight participants completed an online usability questionnaire and 11 completed in-depth interviews. Most questionnaire respondents (86-88%) said the chatbot was "easy to navigate" and "very easy to use," and many (78%) said responses were relevant. The mean CUQ score was 70.2 ± 12.1 and scores ranged from 40.6 to 95.3. Interview participants felt the chatbot achieved high usability due to its strong functionality, performance, and perceived confidentiality, and that the chatbot could attain high credibility with a redesign of its cartoonish visual persona. Young people said they would use the chatbot to discuss vaccination with hesitant friends or family members, while health workers used or anticipated using the chatbot to support community outreach, save time, and stay up to date. This formative study conducted during the pandemic's peak provided user feedback for an iterative redesign of Vira. Taking a mixed-method approach provided multidimensional feedback, identifying how the chatbot worked well-being easy to use, answering questions appropriately, and using credible branding-while offering tangible steps to improve the product's visual design. Future studies should evaluate how chatbots support personal health decision-making, particularly in the context of a public health emergency, and whether such outreach tools can reduce staff burnout. Randomized studies should also measure how chatbots countering health misinformation affect user knowledge, attitudes, and behavior.

A prescription for the US FDA for the regulation of health misinformation.

The US Food and Drug Administration should address health misinformation through existing and new regulatory approaches, including modernizing product labeling, investing in infodemic surveillance and addressing the roles of the internet and social media.

Going beyond fact-checking to fight health misinformation: A multi-level analysis of the Twitter response to health news stories

Health misinformation has become an unfortunate truism of social media platforms, where lies could spread faster than truth. Despite considerable work devoted to suppressing fake news, health misinformation, including low-quality health news, persists and even increases in recent years. One promising approach to fighting bad information is studying the temporal and sentiment effects of health news stories and how they are discussed and disseminated on social media platforms like Twitter. As part of the effort of searching for innovative ways to fight health misinformation, this study analyzes a dataset of more than 1600 objectively and independently reviewed health news stories published over a 10-year span and nearly 50,000 Twitter posts responding to them. Specifically, it examines the source credibility of health news circulated on Twitter and the temporal, sentiment features of the tweets containing or responding to the health news reports. The results show that health news stories that are rated low by experts are discussed more, persist longer, and produce stronger sentiments than highly rated ones in the tweetosphere. However, the highly rated stories retained a fresh interest in the form of new tweets for a longer period. An in-depth understanding of the characteristics of health news distribution and discussion is the first step toward mitigating the surge of health misinformation. The findings provide insights into understanding the mechanism of health information dissemination on social media and practical implications to fight and mitigate health misinformation on digital media platforms.