The effects of corrective information about disease epidemics and outbreaks: Evidence from Zika and yellow fever in Brazil

Have we found a solution for health misinformation? A ten-year systematic review of health misinformation literature 2013-2022

BACKGROUND

Health misinformation (HM) has emerged as a prominent social issue in recent years, driven by declining public trust, popularisation of digital media platforms and escalating public health crisis. Since the Covid-19 pandemic, HM has raised critical concerns due to its significant impacts on both individuals and society as a whole. A comprehensive understanding of HM and HM-related studies would be instrumental in identifying possible solutions to address HM and the associated challenges.

METHODS

Following the PRISMA procedure, 11,739 papers published from January 2013 to December 2022 were retrieved from five electronic databases, and 813 papers matching the inclusion criteria were retained for further analysis. This article critically reviewed HM-related studies, detailing the factors facilitating HM creation and dissemination, negative impacts of HM, solutions to HM, and research methods employed in those studies.

RESULTS

A growing number of studies have focused on HM since 2013. Results of this study highlight that trust plays a significant while latent role in the circuits of HM, facilitating the creation and dissemination of HM, exacerbating the negative impacts of HM and amplifying the difficulty in addressing HM.

CONCLUSION

For health authorities and governmental institutions, it is essential to systematically build public trust in order to reduce the probability of individuals acceptation of HM and to improve the effectiveness of misinformation correction. Future studies should pay more attention to the role of trust in how to address HM.

Using narratives to correct politically charged health misinformation and address affective belief echoes

BACKGROUND

In May 2020, news outlets reported misinformation about the Centers for Disease Control (CDC) related to COVID-19. Correcting misinformation about outbreaks and politics is particularly challenging. Affective belief echoes continue to influence audiences even after successful correction. Narrative and emotional flow scholarship suggest that a narrative corrective with a positive ending could reduce belief echoes. Therefore, this study investigated the efficacy of a narrative corrective with a relief ending for correcting misinformation about the CDC.

METHODS

Between 29 May and 4 June 2020, we tested the effectiveness of a narrative to correct this misinformation. Participants in the United States (N = 469) were enrolled via Qualtrics panels in an online message experiment and randomized to receive a narrative corrective, a didactic corrective or no corrective.

RESULTS

The narrative corrective resulted in lower endorsement of the misinformation compared with the control and the didactic corrective. The narrative corrective had a positive indirect effect on perceived CDC competence and mask wearing intentions for politically moderate and conservative participants via relief.

CONCLUSIONS

Public health institutions, such as the CDC, should consider utilizing narrative messaging with positive emotion endings to correct misinformation. Narratives better address affective belief echoes, particularly for counter-attitudinal audiences.

Mitigating Health and Science Misinformation: A Scoping Review of Literature from 2017 to 2022

Literature on how to address misinformation has rapidly expanded in recent years. The aim of this scoping review was to synthesize the growing published literature on health and science misinformation mitigation interventions. English-language articles published from January 2017 to July 2022 were included. After title/abstract screening, 115 publications (148 empirical studies) met inclusion criteria and were coded for sample characteristics, topics, mitigation strategies, research methods, outcomes, and intervention efficacy. A marked increase in misinformation mitigation research was observed in 2020-2022. COVID-19, vaccines, and climate change were the most frequently addressed topics. Most studies used general population samples recruited online; few focused on populations most vulnerable to misinformation. Most studies assessed cognitive outcomes (e.g., knowledge), with fewer assessing health behavior, communication behavior, or skills. Correction (k = 97) was the most used misinformation mitigation strategy, followed by education and other literacy initiatives (k = 39) and prebunking/inoculation (k = 24). Intervention efficacy varied, with 76 studies reporting positive, 17 reporting null, and 68 reporting mixed results. Most misinformation mitigation interventions were limited to short-term online experiments focused on improving cognitive outcomes. Priority research areas going forward include expanding and diversifying study samples, scaling interventions, conducting longitudinal observations, and focusing on communities susceptible to misinformation.

Covid-19 skepticism and public health norms during refugee assistance: does skepticism always lead to poor safety protocol adherence?

BACKGROUND

Skepticism about COVID-19's existence or severity has spread as fast as the disease itself, and in some populations has been shown to undermine protective public health behaviors that can mitigate infection. For populations that are especially vulnerable to COVID spread and severity, such as refugees, COVID skepticism is particularly problematic.

METHODS

We examine data collected from observations of humanitarian services provided to refugees in Lebanon, Türkiye, and Jordan to determine if skepticism is related to adherence to specific health-protective protocols (masking, social distancing, and hand sanitizing), and whether the effects of COVID skepticism are mediated by particular populations of refugees or the country in which those refugees receive assistance.

RESULTS

We found that community skepticism (the frequency of COVID skepticism expressed by others within a service location) is associated with lower adherence to certain protocols and not others. We also found that with certain protocols, the country in which refugees receive services mediates the relationship between community skepticism and protocol adherence, but for other protocols the relationship between skepticism and adherence is independent of either country in which refugees reside or the refugee population being served.

CONCLUSIONS

The existence of skepticism about COVID-19 does not always lead to an unwillingness to take protective measures to avoid infection. The mechanisms underlying the relationship between skepticism and adherence to health-protective protocols vary based on the type of protocol in question. In order to increase protocol adherence, the specific variables predicting adherence to different protocols need to be assessed in order to increase adherence and improve public health during humanitarian services.

Let's call! Using the phone to increase vaccine acceptance

In the context of the COVID-19 pandemic, we develop and test experimentally three phone-based interventions to increase vaccine acceptance in Mozambique. The first endorses the vaccine with a simple positive message. The second adds the activation of social memory on the country's success in eradicating wild polio with vaccination campaigns. The third further adds a structured interaction with the participant to develop a critical view toward misleading information and minimize the sharing of fake news. We find that combining the endorsement with the stimulation of social memory and the structured interaction increases vaccine acceptance and trust in institutions.

Modernizing the United States' Public Health Infrastructure: A Position Paper From the American College of Physicians

The United States' public health sector plays a crucial role in preventing illness and promoting health. Public health drove massive gains in life expectancy during the 20th century by supporting vaccination campaigns, promoting motor vehicle safety, and preventing and treating tobacco use. However, public health is underfunded and underappreciated, forcing the field to do more with fewer resources. In this position paper, the American College of Physicians (ACP) updates its 2012 policy recommendations on strengthening the nation's public health infrastructure. ACP calls for effective coordination of public health activities, robust and stable year-to-year funding of public health services, a renewed and well-supported public health workforce, action to address health-related dis- and misinformation, modernized public health data systems, and greater coordination between public health and medical sectors.

One Dose Is Not Enough: The Beneficial Effect of Corrective COVID-19 Information Is Diminished If Followed by Misinformation

The World Health Organization (WHO) released a series of mythbuster infographics to combat misinformation during the COVID-19 infodemic. While the corrective effects of such debunking interventions have typically been examined in the immediate aftermath of intervention delivery; the durability of these corrective effects and their resilience against subsequent misinformation remains poorly understood. To this end, we asked younger and older adults to rate the truthfulness and credibility of 10 statements containing misinformation about common COVID-19 myths, as well as their willingness to share the statements through social media. They did this three times, before and after experimental interventions within a single study session. In keeping with established findings, exposure to the WHO's myth-busting infographics-(a) improved participants' ratings of the misinformation statements as untruthful and uncredible and (b) reduced their reported willingness to share the statements. However, within-subject data revealed these beneficial effects were diminished if corrective information was presented shortly by misinformation, but the effects remained when further corrective information was presented. Throughout the study, younger adults rated the misinformation statements as more truthful and credible and were more willing to share them. Our data reveal that the benefit of COVID-19 debunking interventions may be short-lived if followed shortly by misinformation. Still, the effect can be maintained in the presence of further corrective information. These outcomes provide insights into the effectiveness and durability of corrective information and can influence strategies for tackling health-related misinformation, especially in younger adults.

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.

Nutrition care is an integral part of patient-centred medical care: a European consensus

While healthcare is becoming more patient-centred, evidence-based nutrition interventions are still not accessible to all patients with cancer. As nutrition interventions directly improve clinical and socioeconomic outcomes, patient-centred care is not complete without nutrition care. While awareness of the negative impact of malnutrition on clinical outcomes, quality of life, and functional and emotional wellbeing in cancer is growing, there is relatively poor awareness amongst patients, clinicians, policymakers, and payers that nutrition interventions -particularly those begun in the early stages of the disease course- are an effective method for improving such outcomes. The European Beating Cancer Plan recognises the need for a holistic approach to cancer but lacks actionable recommendations to implement integrated nutrition cancer care at member state level. When considering nutrition care as a human right, the impact on quality of life and functional status must be prioritized, as these may be equally as important to patients, especially in advanced cancer where improvements in clinical outcomes such as survival or tumour burden may not be attainable. We formulate actions needed at the regional and the European level to ensure integrated nutrition care for all patients with cancer. The 4 main Take Home Messages are as follows: 1. The goals of Europe's Beating Cancer Plan cannot be achieved without integrating nutrition across the cancer care continuum. 2. Malnutrition negatively impacts clinical outcomes and has socioeconomic consequences for patients and healthcare systems. 3. Championing integrating nutrition care into cancer care is therefore the duty and ethical responsibility of clinicians (Hippocratic Oath-primum non nocere) and 4. Nutrition care is a cost effective, evidence-based therapy.

The roles of risk perception, negative emotions and perceived efficacy in the association between COVID-19 infection cues and preventive behaviors: a moderated mediation model

Preventive behaviors during the COVID-19 pandemic are especially critical to the protection of individuals whose family members or acquaintances have been infected. However, limited research has explored the influence of infection cues on preventive behaviors. This study proposed an interaction model of environment-cognitive/affective-behavior to elucidate the mechanism by which infection cues influence preventive behaviors and the roles of risk perception, negative emotions, and perceived efficacy in that influence. To explore the relationships among these factors, we conducted a cross-sectional online survey in 34 provinces in China during the first wave of the COVID-19 pandemic. A total of 26,511 participants responded to the survey, and 20,205 valid responses (76.2%) were obtained for further analysis. The moderated mediation results show that infection cues positively predicted preventive behaviors in a manner mediated by risk perception and negative emotions. Moreover, perceived efficacy moderated the influence of infection cues not only on preventive behaviors but also on risk perception and negative emotions. The higher the perceived efficacy, the stronger these influences were. These findings validated our model, which elucidates the mechanisms underlying the promoting effect of infection cues on preventive behaviors during the initial stage of the COVID-19 pandemic. The implications of these results for the COVID-19 pandemic and beyond are discussed.

Information, partisanship, and preferences in a pandemic

We investigate the role of information exposure in shaping attitudes and behaviors related to the SARS-CoV-2 (COVID-19) pandemic and whether baseline political affiliation and news diet mediate effects. In December 2020, we randomly assigned 5,009 U.S. adults to nine brief text-based segments related to the dynamics of the pandemic and the safety of various behaviors, estimating the effects on 15 binary outcomes related to COVID-19 policy preferences, expected consumer behavior, and beliefs about safety. Average effects reach significance (95% CI) in 47 out of 120 models and equal 7.4 ppt. The baseline effects are large for all outcomes except beliefs. By contrast, interaction effects by political party and media diet are significant for beliefs but rarely significant for policy and behavioral attitudes. These findings suggest partisan policy and behavioral gaps are driven, at least in part, by exposure to different information and that equalizing information sources would lead to partisan convergence in beliefs.

Why do people believe health misinformation and who is at risk? A systematic review of individual differences in susceptibility to health misinformation

RATIONALE

Health misinformation poses a significant threat to public health. Understanding why people believe health misinformation and who is at risk is crucial for developing effective interventions to reduce the harmful impact of misinformation.

APPROACH

We conducted a systematic review of published empirical research that examined individual differences in susceptibility to health misinformation, focusing on the psychological, demographic, and behavioral correlates of health misinformation susceptibility. To guide our review on psychological correlates, we developed an integrative psychological model of susceptibility to health misinformation based on one's ability and motivation to reason.

RESULTS

We identified 47 publications (61 empirical studies) that met our criteria. Our review suggests that subject knowledge, literacy and numeracy, analytical thinking (vs. intuitive thinking), and trust in science confer strong resistance to health misinformation, whereas conspiracy thinking, religiosity, conservative ideology, and conservative party identification are associated with more susceptibility to health misinformation. Demographically, older age and higher educational attainment predict less susceptibility to health misinformation, whereas racial minority status is associated with greater susceptibility. Behaviorally, relying on health professionals or scientists as information sources predicts less susceptibility to health misinformation, whereas social media use is associated with greater susceptibility.

CONCLUSIONS

Susceptibility to health misinformation is driven by multiple psychological processes. Interventions for reducing the spread and impact of health misinformation should be tailored to the psychological mechanism underlying susceptibility to health misinformation. Limited resources should be used to support interventions targeted at individuals at risk.

Strategies to address conspiracy beliefs and misinformation on COVID-19 in South Africa: A narrative literature review

Conspiracy theories and misinformation have been explored extensively however, strategies to minimise their impact in the context of coronavirus disease 2019 (COVID-19) vaccines are limited. This study aimed to explore strategies that can be used to reduce the negative effects of conspiracies and misinformation about SARS-CoV-2. This review was carried out based on accessed literature on beliefs in misinformation about the COVID-19 pandemic. A comprehensive search of databases, such as Google Scholar, EBSCOhost and African Journals between 2019 and 2022 yielded qualitative and quantitative studies. Two themes emerged, namely underlying motives for conspiracy theories and belief in misinformation about the pandemic and ways to overcome them. The latter included: (1) strengthening critical scanning of information, (2) critical review to address misinformation and (3) establishing approaches for managing conspiracy theories. A proposal is made to address conspiracy beliefs about COVID-19 infection.

CONTRIBUTION

This is believed to be the first review that describes strategies to mitigate belief in conspiracies and misinformation to promote vaccination.

Can Debunked Conspiracy Theories Change Radicalized Views? Evidence from Racial Prejudice and Anti-China Sentiment Amid the COVID-19 Pandemic

With the advent of the 'age of conspiracism', the harmfulness of conspiratorial narratives and mindsets on individuals' mentalities, on social relations, and on democracy, has been widely researched by political scientists and psychologists. One known negative effect of conspiracy theories is the escalation toward political radicalism. This study goes beyond the exploration of mechanisms underpinning the relationship between conspiracy theory and radicalization to focus on possible approaches to mitigating them. This study sheds light on the role of counter-conspiracy approaches in the process of deradicalization, adopting the case study of anti-China sentiment and racial prejudice amid the Covid-19 pandemic, through conducting an experiment (N = 300). The results suggest that, during critical events such as the Covid-19 pandemic, exposure to countermeasures to conspiracist information can reduce individual acceptance of radicalism. We investigated two methods of countering conspiracy theory, and found that: (1) a content-targeted 'inoculation' approach to countering conspiracy theory can prevent the intensification of radicalization, but does not produce a significant deradicalization effect; and (2) an audience-focused 'disenchantment' method can enable cognitive deradicalization, effectively reducing the perception of competitive victimhood, and of real and symbolic threats. This study is one of the first attempts to address causality between deradicalization and countermeasures to conspiracy theories in the US-China relations.

What do university students say about online learning and the COVID-19 pandemic in central Fiji? A qualitative study

Globally, the spread of COVID-19 has led to the closure of schools, thereby accelerating the expansion of the online learning environment. Though, Fiji National University students' (FNU), had no option than to quickly adopt to this mode of learning, within limited period, their learning experiences are yet to be examined and documented. We used phenomenological study design to explore students' online learning challenges, coping strategies and their perceptions on the causes of COVID-19. A total of 120 in-depth interviews were conducted with FNU students, at different levels and colleges, and analysed thematically, using inductive approach. The three themes emerged included COVID-19 misconception beliefs among students, online learning challenges during the COVID-19 pandemic and online learning coping strategies during the COVID-19 pandemic. The misconception beliefs identified were natural occurrence, manmade for depopulation, unreal/fake and as a means of soliciting for funds. The challenges included ineffective tutorial sessions, lack of learning devices, unstable internet service, inadequate learning environment, socio-cultural practices, feeling of loneliness, anxiety and stress, and difficulties accessing online platforms and acquiring practical skills. The coping strategies used by students ranged from support from family and counsellors, help-seeking, frequent communication, time management, learning flexibility to control over learning environment. The findings highlight the need for policy makers, school managers, lecturers and other key stakeholders to address online learning challenges to improve online learning among FNU students. Relevant information should be provided on the COVID-19 pandemic to clear misconceptions.

Unmasking the Twitter Discourses on Masks During the COVID-19 Pandemic: User Cluster-Based BERT Topic Modeling Approach

BACKGROUND

The COVID-19 pandemic has spotlighted the politicization of public health issues. A public health monitoring tool must be equipped to reveal a public health measure's political context and guide better interventions. In its current form, infoveillance tends to neglect identity and interest-based users, hence being limited in exposing how public health discourse varies by different political groups. Adopting an algorithmic tool to classify users and their short social media texts might remedy that limitation.

OBJECTIVE

We aimed to implement a new computational framework to investigate discourses and temporal changes in topics unique to different user clusters. The framework was developed to contextualize how web-based public health discourse varies by identity and interest-based user clusters. We used masks and mask wearing during the early stage of the COVID-19 pandemic in the English-speaking world as a case study to illustrate the application of the framework.

METHODS

We first clustered Twitter users based on their identities and interests as expressed through Twitter bio pages. Exploratory text network analysis reveals salient political, social, and professional identities of various user clusters. It then uses BERT Topic modeling to identify topics by the user clusters. It reveals how web-based discourse has shifted over time and varied by 4 user clusters: conservative, progressive, general public, and public health professionals.

RESULTS

This study demonstrated the importance of a priori user classification and longitudinal topical trends in understanding the political context of web-based public health discourse. The framework reveals that the political groups and the general public focused on the science of mask wearing and the partisan politics of mask policies. A populist discourse that pits citizens against elites and institutions was identified in some tweets. Politicians (such as Donald Trump) and geopolitical tensions with China were found to drive the discourse. It also shows limited participation of public health professionals compared with other users.

CONCLUSIONS

We conclude by discussing the importance of a priori user classification in analyzing web-based discourse and illustrating the fit of BERT Topic modeling in identifying contextualized topics in short social media texts.

Are socio-demographic and economic characteristics good predictors of misinformation during an epidemic?

We combine data on beliefs about the origin of the 2014 Ebola outbreak with two supervised machine learning methods to predict who is more likely to be misinformed. Contrary to popular beliefs, we uncover that, socio-demographic and economic indicators play a minor role in predicting those who are misinformed: misinformed individuals are not any poorer, older, less educated, more economically distressed, more rural, or ethnically different than individuals who are informed. However, they are more likely to report high levels of distrust, especially towards governmental institutions. By distinguishing between types of beliefs, distrust in the central government is the primary predictor of individuals assigning a political origin to the epidemic, while Muslim religion is the most important predictor of whether the individual assigns a supernatural origin. Instead, educational level has a markedly higher importance for ethnic beliefs. Taken together, the results highlight that government trust might play the most important role in reducing misinformation during epidemics.

Moral conviction: A challenge in the age of science politicization

Social science research can help science practitioners understand why the public responds to scientific findings differentially-sometimes believing, sometimes not. Four decades of research finds that people interpret science in ways that make it easier to dismiss scientific findings or consensuses that go against specific attitudes, or positions in social and policy debates, that they wish to maintain. This may be the case especially when a person's position is a moral conviction-that is, it is not only their preferred position, but what they feel is the morally correct position. This chapter explores why moral conviction matters for understanding public response to scientific information in the age of politicization, where moral conviction comes from, and the ways in which it poses a challenge to the foundations of science.

Vax attacks: How conspiracy theory belief undermines vaccine support

As the world continues to respond to the spread of a novel coronavirus (SARS-CoV-2, which causes the disease commonly known as COVID-19), it has become clear that one of the most effective strategies for curbing the pandemic is the COVID-19 vaccine. However, a major challenge that health organizations face when advocating for the uptake of the COVID-19 vaccine is the spread of related misinformation and conspiracy theories. This study examines factors that influence vaccine hesitancy using two online survey samples, one convenience and one nationally representative, collected in the early summer of 2020 during the height of the second peak of coronavirus cases in the United States. Given extant literature on vaccine hesitancy and conspiracy belief, we expect that three factors—conspiracy theory belief, political identity, and anti-intellectualism—have served to reduce COVID-19 vaccination likelihood. Accordingly, across our two independent samples we find that anti-intellectualism, conspiratorial predispositions, and COVID-19 conspiracy theory belief are the strongest and most consistent predictors of COVID-19 vaccine hesitancy. Notably, we also find that partisanship and political ideology are inconsistently significant predictors of COVID-19 vaccine hesitancy once conspiracy theory beliefs, anti-intellectualism, and control variables are accounted for in the models. When political tendencies are significant, they demonstrate a relatively small substantive association with COVID-19 vaccine hesitancy. We discuss implications for ongoing mass vaccination efforts, continued widespread vaccine hesitancy, and related political attitudes.

The ephemeral effects of fact-checks on COVID-19 misperceptions in the United States, Great Britain and Canada

Widespread misperceptions about COVID-19 and the novel coronavirus threaten to exacerbate the severity of the pandemic. We conducted preregistered survey experiments in the United States, Great Britain and Canada examining the effectiveness of fact-checks that seek to correct these false or unsupported beliefs. Across three countries with differing levels of political conflict over the pandemic response, we demonstrate that fact-checks reduce targeted misperceptions, especially among the groups who are most vulnerable to these claims, and have minimal spillover effects on the accuracy of related beliefs. However, these reductions in COVID-19 misperception beliefs do not persist over time in panel data even after repeated exposure. These results suggest that fact-checks can successfully change the COVID-19 beliefs of the people who would benefit from them most but that their effects are ephemeral.

(Mis)Information on Digital Platforms: Quantitative and Qualitative Analysis of Content From Twitter and Sina Weibo in the COVID-19 Pandemic

BACKGROUND

Misinformation about COVID-19 on social media has presented challenges to public health authorities during the pandemic. This paper leverages qualitative and quantitative content analysis on cross-platform, cross-national discourse and misinformation in the context of COVID-19. Specifically, we investigated COVID-19-related content on Twitter and Sina Weibo-the largest microblogging sites in the United States and China, respectively.

OBJECTIVE

Using data from 2 prominent microblogging platform, Twitter, based in the United States, and Sina Weibo, based in China, we compared the content and relative prevalence of misinformation to better understand public discourse of public health issues across social media and cultural contexts.

METHODS

A total of 3,579,575 posts were scraped from both Sina Weibo and Twitter, focusing on content from January 30, 2020, within 24 hours of when WHO declared COVID-19 a "public health emergency of international concern," and a week later, on February 6, 2020. We examined how the use and engagement measured by keyword frequencies and hashtags differ across the 2 platforms. A 1% random sample of tweets that contained both the English keywords "coronavirus" and "covid-19" and the equivalent Chinese characters was extracted and analyzed based on changes in the frequencies of keywords and hashtags and the Viterbi algorithm. We manually coded a random selection of 5%-7% of the content to identify misinformation on each platform and compared posts using the WHO fact-check page to adjudicate accuracy of content.

RESULTS

Both platforms posted about the outbreak and transmission, but posts on Sina Weibo were less likely to reference topics such as WHO, Hong Kong, and death and more likely to cite themes of resisting, fighting, and cheering against coronavirus. Misinformation constituted 1.1% of Twitter content and 0.3% of Sina Weibo content-almost 4 times as much on Twitter compared to Sina Weibo.

CONCLUSIONS

Quantitative and qualitative analysis of content on both platforms points to lower degrees of misinformation, more content designed to bolster morale, and less reference to topics such as WHO, death, and Hong Kong on Sina Weibo than on Twitter.

False beliefs about sleep and their associations with sleep-related behavior

OBJECTIVES

Understanding the association between sleep-related beliefs and behaviors may be useful in improving sleep health in the general population. This study examines false beliefs about sleep and their associations with self-reported sleep and related behaviors.

METHODS

Respondents in an online survey indicated the degree to which they agreed with 20 statements previously identified as sleep myths by experts in the field. A total sleep myths score was calculated for each participant, with higher scores reflecting greater false beliefs. Sociodemographic factors, behaviors, and knowledge related to sleep were also assessed.

RESULTS

Total sample size was 1120 adults residing in the United States (51.5% female; M age = 47.22). Overall, belief in sleep myths was relatively common, with 10 of 20 false statements endorsed by at least 50% of the sample. Sleep myth scores varied by sociodemographic factors, including age, gender, socioeconomic indicators, and region of residence. Higher sleep myth scores were associated with greater inconsistency in bedtimes (odds ratio: 1.07 [1.04-1.09]), more frequent napping (odds ratio: 1.11 [1.09-1.14]), more in-bed activities (β = 0.35, p < .001), engaging in behaviors incompatible with sleep hygiene recommendations (β = 0.24, p < .001), and perceiving fewer consequences of insufficient sleep (β = -0.13, p < .001). Those endorsing more myths reported shorter sleep on non-worknights (β = -0.09, p = .01) but not on worknights.

CONCLUSIONS

Belief in sleep myths is related to sleep health behavior and may be a modifiable target for intervention.

Understanding the Relationship Between Official and Social Information About Infectious Disease: Experimental Analysis

BACKGROUND

Communicating official public health information about infectious diseases is complicated by the fact that individuals receive much of their information from their social contacts, either via interpersonal interaction or social media, which can be prone to bias and misconception.

OBJECTIVE

This study aims to evaluate the effect of public health campaigns and the effect of socially communicated health information on learning about diseases simultaneously. Although extant literature addresses the effect of one source of information (official or social) or the other, it has not addressed the simultaneous interaction of official information (OI) and social information (SI) in an experimental setting.

METHODS

We used a series of experiments that exposed participants to both OI and structured SI about the symptoms and spread of hepatitis C over a series of 10 rounds of computer-based interactions. Participants were randomly assigned to receive a high, low, or control intensity of OI and to receive accurate or inaccurate SI about the disease.

RESULTS

A total of 195 participants consented to participate in the study. Of these respondents, 186 had complete responses across all ten experimental rounds, which corresponds to a 4.6% (9/195) nonresponse rate. The OI high intensity treatment increases learning over the control condition for all symptom and contagion questions when individuals have lower levels of baseline knowledge (all P values ≤.04). The accurate SI condition increased learning across experimental rounds over the inaccurate condition (all P values ≤.01). We find limited evidence of an interaction between official and SI about infectious diseases.

CONCLUSIONS

This project demonstrates that exposure to official public health information increases individuals' knowledge of the spread and symptoms of a disease. Socially shared information also facilitates the learning of accurate and inaccurate information, though to a lesser extent than exposure to OI. Although the effect of OI persists, preliminary results suggest that it can be degraded by persistent contradictory SI over time.

Debunking highly prevalent health misinformation using audio dramas delivered by WhatsApp: evidence from a randomised controlled trial in Sierra Leone

Introduction

Infectious disease misinformation is widespread and poses challenges to disease control. There is limited evidence on how to effectively counter health misinformation in a community setting, particularly in low-income regions, and unsettled scientific debate about whether misinformation should be directly discussed and debunked, or implicitly countered by providing scientifically correct information.

Methods

The Contagious Misinformation Trial developed and tested interventions designed to counter highly prevalent infectious disease misinformation in Sierra Leone, namely the beliefs that (1) mosquitoes cause typhoid and (2) typhoid co-occurs with malaria. The information intervention for group A (n=246) explicitly discussed misinformation and explained why it was incorrect and then provided the scientifically correct information. The intervention for group B (n=245) only focused on providing correct information, without directly discussing related misinformation. Both interventions were delivered via audio dramas on WhatsApp that incorporated local cultural understandings of typhoid. Participants were randomised 1:1:1 to the intervention groups or the control group (n=245), who received two episodes about breast feeding.

Results

At baseline 51% believed that typhoid is caused by mosquitoes and 59% believed that typhoid and malaria always co-occur. The endline survey was completed by 91% of participants. Results from the intention-to-treat, per-protocol and as-treated analyses show that both interventions substantially reduced belief in misinformation compared with the control group. Estimates from these analyses, as well as an exploratory dose–response analysis, suggest that direct debunking may be more effective at countering misinformation. Both interventions improved people’s knowledge and self-reported behaviour around typhoid risk reduction, and yielded self-reported increases in an important preventive method, drinking treated water.

Conclusion

These results from a field experiment in a community setting show that highly prevalent health misinformation can be countered, and that direct, detailed debunking may be most effective.

Trial registration number

NCT04112680.

Designing a conceptual framework for misinformation on social media: a qualitative study on COVID-19

OBJECTIVE

This study was aimed to present a conceptual framework about the misinformation surrounding COVID-19 outbreak in Iran. For this purpose, discourse analysis of two of the most common social virtual networks were conducted via a four step approach as follows: defining the research question and selecting the content of analysis, gathering information and theory on the context, content analysis for establishing the themes and patterns and, presenting the results and drawing conclusions.

RESULTS

Cultural factors, demand pressure for information during the crisis, the easiness of information dissemination via social networks, marketing incentives and the poor legal supervision of online content are the main reasons for misinformation dissemination. Disease statistics; treatments and prevention are the main subjective categories of releasing misinformation. The consequences of misinformation dissemination include psychosocial, economic, health status, health system and ethical ones. The most recommended strategies for dealing with the issue could be divided into demand and supply-side strategies.

Addressing Myths and Vaccine Hesitancy: A Randomized Trial

OBJECTIVES

Evidence on repeating vaccination misinformation or "myths" in debunking text is inconclusive; repeating myths may unintentionally increase agreement with myths or help discredit myths. In this study we aimed to compare the effect of repeating vaccination myths and other text-based debunking strategies on parents' agreement with myths and their intention to vaccinate their children.

METHODS

For this online experiment we recruited 788 parents of children aged 0 to 5 years; 454 (58%) completed the study. We compared 3 text-based debunking strategies (repeating myths, posing questions, or making factual statements) and a control. We measured changes in agreement with myths and intention to vaccinate immediately after the intervention and at least 1 week later. The primary analysis compared the change in agreement with vaccination myths from baseline, between groups, at each time point after the intervention.

RESULTS

There was no evidence that repeating myths increased agreement with myths compared with the other debunking strategies or the control. Posing questions significantly decreased agreement with myths immediately after the intervention compared with the control (difference: -0.30 points, 99.17% confidence interval: -0.58 to -0.02, P = .004, d = 0.39). There was no evidence of a difference between other debunking strategies or the control at either time point, or on intention to vaccinate.

CONCLUSIONS

Debunking strategies that repeat vaccination myths do not appear to be inferior to strategies that do not repeat myths.

The role of self-evaluation in predicting attitudes toward supporters of COVID-19-related conspiracy theories: A direct and a conceptual replication of Cichocka et al. (2016)

We examined the role of people’s self-evaluation in predicting their attitudes toward supporters of COVID-19-related conspiracy theories by replicating and extending the findings of a study by Cichocka et al. (2016, Study 3) in two preregistered studies (total N = 1179). Study 1, a direct replication, confirmed that narcissism and self-esteem—two different sources of people’s self-evaluation—differentially predicted their beliefs in a series of well-known conspiracy theories (not related to COVID-19), and served as mutual suppressor variables. Specifically, narcissism was positively related and self-esteem was negatively related to conspiracy beliefs, especially when the respective other predictor was controlled for. Study 2 extended Cichocka’s and our Study 1’s findings by testing the differential role of self-esteem and narcissism in predicting a COVID-19-specific criterion. Specifically, we focused on people’s rejection of supporters of COVID-19 conspiracy theories, a criterion we deem particularly important in curtailing the spread of these theories. Results were generally in line with previous findings, but effects were substantially weaker. As suggested by exploratory analyses, this might be due to the fact that the overall rejection of supporters measure comprises not only items capturing rejection of supporters but also items capturing low beliefs in conspiracy theories. These two distinct components differentially related to self-esteem and narcissism: the differential role of self-esteem and narcissism could only be replicated for the “low belief” subcomponent (thus replicating findings from the original study and from Study 1) but not for the “rejection of supporters” subcomponent. The present work thus contributes to recent research suggesting that low belief in conspiracy theories and the rejection of their supporters might be qualitatively different responses with unique antecedents.

Messages that increase COVID-19 vaccine acceptance: Evidence from online experiments in six Latin American countries

As safe and effective vaccines become widely available, attaining herd immunity and limiting the spread of COVID-19 will depend on individuals choosing to vaccinate—and doing so quickly enough to outpace mutations. Using online surveys conducted across six Latin American countries in January 2021, we experimentally assess messages designed to counteract informational deficiencies and collective action problems that may drive hesitancy. We first find that basic vaccine information persuades around 8% of hesitant individuals to become willing to vaccinate, reduces intended wait to vaccinate by 0.4 months, and increases willingness to encourage others to vaccinate. Rather than facilitating free riding, learning, or social conformity, additional information about others’ behavior increases vaccine acceptance when respondents expect herd immunity will be achieved. Finally, priming the social approval benefits of vaccinating also increases vaccine acceptance. These results suggest that providing information and shaping social expectations and incentives could both significantly increase vaccine uptake.

Science skepticism reduced compliance with COVID-19 shelter-in-place policies in the United States

Physical distancing reduces transmission risks and slows the spread of COVID-19. Yet compliance with shelter-in-place policies issued by local and regional governments in the United States was uneven and may have been influenced by science skepticism and attitudes towards topics of scientific consensus. Using county-day measures of physical distancing derived from cell phone location data, we demonstrate that the proportion of people who stayed at home after shelter-in-place policies went into effect in March and April 2020 in the United States was significantly lower in counties with a high concentration of science skeptics. These results are robust to controlling for other potential drivers of differential physical distancing, such as political partisanship, income, education and COVID severity. Our findings suggest that public health interventions that take local attitudes towards science into account in their messaging may be more effective.

The global effectiveness of fact-checking: Evidence from simultaneous experiments in Argentina, Nigeria, South Africa, and the United Kingdom

The spread of misinformation is a global phenomenon, with implications for elections, state-sanctioned violence, and health outcomes. Yet, even though scholars have investigated the capacity of fact-checking to reduce belief in misinformation, little evidence exists on the global effectiveness of this approach. We describe fact-checking experiments conducted simultaneously in Argentina, Nigeria, South Africa, and the United Kingdom, in which we studied whether fact-checking can durably reduce belief in misinformation. In total, we evaluated 22 fact-checks, including two that were tested in all four countries. Fact-checking reduced belief in misinformation, with most effects still apparent more than 2 wk later. A meta-analytic procedure indicates that fact-checks reduced belief in misinformation by at least 0.59 points on a 5-point scale. Exposure to misinformation, however, only increased false beliefs by less than 0.07 points on the same scale. Across continents, fact-checks reduce belief in misinformation, often durably so.

No one is immune to misinformation: An investigation of misinformation sharing by subscribers to a fact-checking newsletter

Like other disease outbreaks, the COVID-19 pandemic has led to the rapid generation and dissemination of misinformation and fake news. We investigated whether subscribers to a fact checking newsletter (n = 1397) were willing to share possible misinformation, and whether predictors of possible misinformation sharing are the same as for general samples. We also investigated predictors of willingness to have a COVID-19 vaccine and found that although vaccine acceptance was high on average, it decreased as a function of lower belief in science and higher conspiracy mentality. We found that 24% of participants had shared possible misinformation and that this was predicted by a lower belief in science. Like general samples, our participants were typically motivated to share possible misinformation due to interest in the information, or to seek a second opinion about claim veracity. However, even if information is shared in good faith and not for the purpose of deceiving or misleading others, the spread of misinformation is nevertheless highly problematic. Exposure to misinformation engenders faulty beliefs in others and undermines efforts to curtail the spread of COVID-19 by reducing adherence to social distancing measures and increasing vaccine hesitancy.

Rational thinking style, rejection of coronavirus (COVID-19) conspiracy theories/theorists, and compliance with mandated requirements

Faced with the threat posed by the COVID-19 pandemic, many nations have mandated sets of requirements, such as social-distancing measures. However, compliance with such measures is likely to be shaped by a range of factors. Here, we proposed and tested a mediation model in which rejection of COVID-19 conspiracy theories and/or theorists mediates the relationship between rational thinking style and compliance with mandated requirements. An online, nationally representative sample of the adult population in the United Kingdom ( N = 520) completed a previously validated measure of rational thinking style, as well as novel measures of rejection of COVID-19 conspiracy theories/theorists and compliance with mandated requirements. Intercorrelations between scores on all three measures were significant and positive. Mediation analysis indicated that rational thinking style and rejection of COVID-19 conspiracy theories/theorists, respectively, were directly associated with compliance, and that the mediated association was also significant. These results may have implications for practical policy aimed at promoting greater compliance with mandated requirements, including social distancing.

The information-seeking behavior and levels of knowledge, precaution, and fear of college students in Iloilo, Philippines amidst the COVID-19 pandemic

COVID-19 pandemic is devastating the health, social, and economic well-being of citizens worldwide. The high rates of morbidity and mortality and the absence of vaccines cause fear among the people regardless of age, gender, or social status. People's fear is heightened by misinformation spread across all media types, especially on social media. Filipino college students are one of the top Internet users worldwide and are very active in social media. Hence they are very prone to misinformation. This paper aims to ascertain the levels of knowledge, precaution, and fear of COVID-19 of the college students in Iloilo, Philippines, and determine the effects of their information-seeking behavior on the variables above. This paper is a cross-sectional survey that used a qualitative-quantitative method and snowball sampling technique. Data were gathered among 228 college students using an online survey instrument a few months after the pandemic began. College students were knowledgeable of the basic facts about the highly infectious COVID-19. However, the majority were inclined to believe the myths and misinformation regarding the pandemic. Television was the primary, most believable, and preferred source when seeking information. The Internet as a preferred source of information was significantly associated with a high level of knowledge. In contrast, the information sourced from interpersonal channels were found to make college students very cautious. The local presence of COVID-19 cases had caused college students to fear, likely exacerbated by the plethora of information about the pandemic, mostly from Facebook. This is the first study conducted on the effects of the information-seeking behavior on the levels of knowledge, precaution, and fear of COVID-19 of the college students in Iloilo, Philippines.

What Should I Trust? Individual Differences in Attitudes to Conflicting Information and Misinformation on COVID-19

The COVID-19 pandemic constitutes a novel threat and traditional and new media provide people with an abundance of information and misinformation on the topic. In the current study, we investigated who tends to trust what type of mis/information. The data were collected in Norway from a sample of 405 participants during the first wave of COVID-19 in April 2020. We focused on three kinds of belief: the belief that the threat is overrated (COVID-threat skepticism), the belief that the threat is underrated (COVID-threat belief) and belief in misinformation about COVID-19. We studied sociodemographic factors associated with these beliefs and the interplay between attitudes to COVID-19, media consumption and prevention behavior. All three types of belief were associated with distrust in information about COVID-19 provided by traditional media and distrust in the authorities' approach to the pandemic. COVID-threat skepticism was associated with male gender, reduced news consumption since the start of the pandemic and lower levels of precautionary measures. Belief that the COVID-19 threat is underrated was associated with younger age, left-wing political orientation, increased news consumption during the pandemic and increased precautionary behavior. Consistent with the assumptions of the theory of planned behavior, individual beliefs about the seriousness of the COVID-19 threat predicted the extent to which individual participants adopted precautionary health measures. Both COVID-threat skepticism and COVID-threat belief were associated with endorsement of misinformation on COVID-19. Participants who endorsed misinformation tended to: have lower levels of education; be male; show decreased news consumption; have high Internet use and high trust in information provided by social media. Additionally, they tended to endorse multiple misinformation stories simultaneously, even when they were mutually contradictory. The strongest predictor for low compliance with precautionary measures was endorsement of a belief that the COVID-19 threat is overrated which at the time of the data collection was held also by some experts and featured in traditional media. The findings stress the importance of consistency of communication in situations of a public health threat.

Understanding misinformation infodemic during public health emergencies due to large-scale disease outbreaks: a rapid review

AIM

The coronavirus disease 2019 (COVID-19) has caused hundreds of thousands of deaths, impacted the flow of life and resulted in an immeasurable amount of socio-economic damage. However, not all of this damage is attributable to the disease itself; much of it has occurred due to the prevailing misinformation around COVID-19. This rapid integrative review will draw on knowledge from the literature about misinformation during previous abrupt large-scale infectious disease outbreaks to enable policymakers, governments and health institutions to proactively mitigate the spread and effect of misinformation.

SUBJECT AND METHODS

For this rapid integrative review, we systematically searched MEDLINE and Google Scholar and extracted the literature on misinformation during abrupt large-scale infectious disease outbreaks since 2000. We screened articles using predetermined inclusion criteria. We followed an updated methodology for integrated reviews and adjusted it for our rapid review approach.

RESULTS

We found widespread misinformation in all aspects of large-scale infectious disease outbreaks since 2000, including prevention, treatment, risk factor, transmission mode, complications and vaccines. Conspiracy theories also prevailed, particularly involving vaccines. Misinformation most frequently has been reported regarding Ebola, and women and youth are particularly vulnerable to misinformation. A lack of scientific knowledge by individuals and a lack of trust in the government increased the consumption of misinformation, which is disseminated quickly by the unregulated media, particularly social media.

CONCLUSION

This review identified the nature and pattern of misinformation during large-scale infectious disease outbreaks, which could potentially be used to address misinformation during the ongoing COVID-19 or any future pandemic.

Unwillingness to engage in behaviors that protect against COVID-19: the role of conspiracy beliefs, trust, and endorsement of complementary and alternative medicine

BACKGROUND

We investigated if people's response to the official recommendations during the COVID-19 pandemic is associated with conspiracy beliefs related to COVID-19, a distrust in the sources providing information on COVID-19, and an endorsement of complementary and alternative medicine (CAM).

METHODS

The sample consisted of 1325 Finnish adults who filled out an online survey marketed on Facebook. Structural regression analysis was used to investigate whether: 1) conspiracy beliefs, a distrust in information sources, and endorsement of CAM predict people's response to the non-pharmaceutical interventions (NPIs) implemented by the government during the COVID-19 pandemic, and 2) conspiracy beliefs, a distrust in information sources, and endorsement of CAM are related to people's willingness to take a COVID-19 vaccine.

RESULTS

Individuals with more conspiracy beliefs and a lower trust in information sources were less likely to have a positive response to the NPIs. Individuals with less trust in information sources and more endorsement of CAM were more unwilling to take a COVID-19 vaccine. Distrust in information sources was the strongest and most consistent predictor in all models. Our analyses also revealed that some of the people who respond negatively to the NPIs also have a lower likelihood to take the vaccine. This association was partly related to a lower trust in information sources.

CONCLUSIONS

Distrusting the establishment to provide accurate information, believing in conspiracy theories, and endorsing treatments and substances that are not part of conventional medicine, are all associated with a more negative response to the official guidelines during COVID-19. How people respond to the guidelines, however, is more strongly and consistently related to the degree of trust they feel in the information sources, than to their tendency to hold conspiracy beliefs or endorse CAM. These findings highlight the need for governments and health authorities to create communication strategies that build public trust.

Use of bot and content flags to limit the spread of misinformation among social networks: a behavior and attitude survey

The COVID-19 infodemic is driven partially by Twitter bots. Flagging bot accounts and the misinformation they share could provide one strategy for preventing the spread of false information online. This article reports on an experiment (N = 299) conducted with participants in the USA to see whether flagging tweets as coming from bot accounts and as containing misinformation can lower participants’ self-reported engagement and attitudes about the tweets. This experiment also showed participants tweets that aligned with their previously held beliefs to determine how flags affect their overall opinions. Results showed that flagging tweets lowered participants’ attitudes about them, though this effect was less pronounced in participants who frequently used social media or consumed more news, especially from Facebook or Fox News. Some participants also changed their opinions after seeing the flagged tweets. The results suggest that social media companies can flag suspicious or inaccurate content as a way to fight misinformation. Flagging could be built into future automated fact-checking systems and other misinformation abatement strategies of the social network analysis and mining community.

How do social media and individual behaviors affect epidemic transmission and control?

In the outbreak of infectious diseases such as COVID-19, social media channels are important tools for the public to obtain information and form their opinions on infection risk, which can affect their disease prevention behaviors and the consequent disease transmission processes. However, there has been a lack of theoretical investigation into how social media and human behaviors jointly affect the spread of infectious diseases. In this study, we develop an agent-based modeling framework that couples (1) a general opinion dynamics model that describes how individuals form their opinions on epidemic risk with various information sources, (2) a behavioral adoption model that simulates the adoption of disease prevention behaviors, and (3) an epidemiological SEIR model that simulates the spread of diseases in a host population. Through simulating the spread of a coronavirus-like disease in a hypothetical residential area, the modeling results show that social media can make a community more sensitive to external drivers. Social media can increase the public's awareness of infection risk, which is beneficial for epidemic containment, when high-quality epidemic information exists at the early stage of pandemics. However, fabricated and fake news on social media, after a "latent period", can lead to a significant increase in infection rate. The modeling results provide scientific evidence for the intricate interplay between social media and human behaviors in epidemic dynamics and control, and highlight the importance of public education to promote behavioral changes and the need to correct misinformation and fake news on social media in a timely manner.

Infection threat shapes our social instincts

We social animals must balance the need to avoid infections with the need to interact with conspecifics. To that end we have evolved, alongside our physiological immune system, a suite of behaviors devised to deal with potentially contagious individuals. Focusing mostly on humans, the current review describes the design and biological innards of this behavioral immune system, laying out how infection threat shapes sociality and sociality shapes infection threat. The paper shows how the danger of contagion is detected and posted to the brain; how it affects individuals’ mate choice and sex life; why it strengthens ties within groups but severs those between them, leading to hostility toward anyone who looks, smells, or behaves unusually; and how it permeates the foundation of our moral and political views. This system was already in place when agriculture and animal domestication set off a massive increase in our population density, personal connections, and interaction with other species, amplifying enormously the spread of disease. Alas, pandemics such as COVID-19 not only are a disaster for public health, but, by rousing millions of behavioral immune systems, could prove a threat to harmonious cohabitation too.

Characterizing the COVID-19 Infodemic on Chinese Social Media: Exploratory Study

BACKGROUND

The COVID-19 infodemic has been disseminating rapidly on social media and posing a significant threat to people's health and governance systems.

OBJECTIVE

This study aimed to investigate and analyze posts related to COVID-19 misinformation on major Chinese social media platforms in order to characterize the COVID-19 infodemic.

METHODS

We collected posts related to COVID-19 misinformation published on major Chinese social media platforms from January 20 to May 28, 2020, by using PythonToolkit. We used content analysis to identify the quantity and source of prevalent posts and topic modeling to cluster themes related to the COVID-19 infodemic. Furthermore, we explored the quantity, sources, and theme characteristics of the COVID-19 infodemic over time.

RESULTS

The daily number of social media posts related to the COVID-19 infodemic was positively correlated with the daily number of newly confirmed (r=0.672, P<.01) and newly suspected (r=0.497, P<.01) COVID-19 cases. The COVID-19 infodemic showed a characteristic of gradual progress, which can be divided into 5 stages: incubation, outbreak, stalemate, control, and recovery. The sources of the COVID-19 infodemic can be divided into 5 types: chat platforms (1100/2745, 40.07%), video-sharing platforms (642/2745, 23.39%), news-sharing platforms (607/2745, 22.11%), health care platforms (239/2745, 8.71%), and Q&A platforms (157/2745, 5.72%), which slightly differed at each stage. The themes related to the COVID-19 infodemic were clustered into 8 categories: "conspiracy theories" (648/2745, 23.61%), "government response" (544/2745, 19.82%), "prevention action" (411/2745, 14.97%), "new cases" (365/2745, 13.30%), "transmission routes" (244/2745, 8.89%), "origin and nomenclature" (228/2745, 8.30%), "vaccines and medicines" (154/2745, 5.61%), and "symptoms and detection" (151/2745, 5.50%), which were prominently diverse at different stages. Additionally, the COVID-19 infodemic showed the characteristic of repeated fluctuations.

CONCLUSIONS

Our study found that the COVID-19 infodemic on Chinese social media was characterized by gradual progress, videoization, and repeated fluctuations. Furthermore, our findings suggest that the COVID-19 infodemic is paralleled to the propagation of the COVID-19 epidemic. We have tracked the COVID-19 infodemic across Chinese social media, providing critical new insights into the characteristics of the infodemic and pointing out opportunities for preventing and controlling the COVID-19 infodemic.

Addressing COVID-19 Misinformation on Social Media Preemptively and Responsively

Efforts to address misinformation on social media have special urgency with the emergence of coronavirus disease (COVID-19). In one effort, the World Health Organization (WHO) designed and publicized shareable infographics to debunk coronavirus myths. We used an experiment to test the efficacy of these infographics, depending on placement and source. We found that exposure to a corrective graphic on social media reduced misperceptions about the science of 1 false COVID-19 prevention strategy but did not affect misperceptions about prevention of COVID-19. Lowered misperceptions about the science persisted >1 week later. These effects were consistent when the graphic was shared by the World Health Organization or by an anonymous Facebook user and when the graphics were shared preemptively or in response to misinformation. Health organizations can and should create and promote shareable graphics to improve public knowledge.

Myths, beliefs, and perceptions about COVID-19 in Ethiopia: A need to address information gaps and enable combating efforts

BACKGROUND

The endeavor to tackle the spread of COVID-19 effectively remains futile without the right grasp of perceptions and beliefs presiding in the community. Therefore, this study aimed to assess myths, beliefs, perceptions, and information gaps about COVID-19 in Ethiopia.

METHODS

An internet-based survey was conducted in Ethiopia from April 22 to May 04, 2020. The survey link was promoted through emails, social media, and the Jimma University website. Perceptions about COVID-19 have considered the World Health Organization (WHO) resources and local beliefs. The data were analyzed using Statistical Package for Social Science (SPSS) software version 20.0. Classifications and lists of factors for each thematic perception of facilitators, inhibitors, and information needs were generated. Explanatory factor analysis (EFA) was executed to assist categorizations. Standardized mean scores of the categories were compared using analysis of variance (ANOVA) and t-tests. A significant difference was claimed at p-value <0.05.

RESULTS

A total of 929 responses were gathered during the study period. The EFA generated two main categories of perceived facilitators of COVID-19 spread: behavioral non-adherence (55.9%) and lack of enablers (86.5%). Behavioral non-adherence was illustrated by fear of stigma (62.9%), not seeking care (59.3%), and hugging and shaking (44.8%). Perceived lack of enablers of precautionary measures includes staying home impossible due to economic challenges (92.4%), overcrowding (87.6%), and inaccessible face masks (81.6%) and hand sanitizers (79.1%). Perceived inhibitors were categorized into three factors: two misperceived, myths (31.6%) and false assurances (32.9%), and one correctly identified; engagement in standard precautions (17.1%). Myths about protection from the virus involve perceived religiosity and effectiveness of selected food items, hot weather, traditional medicine, and alcohol drinking, ranging from 15.1% to 54.7%. False assurances include people's perception that they were living far away from areas where COVID-19 was rampant (36.9%), and no locally reported cases were present (29.5%). There were tremendous information needs reported about COVID-19 concerning protection methods (62.6%), illness behavior and treatment (59.5%), and quality information, including responses to key unanswered questions such as the origin of the virus (2.4%). Health workers were perceived as the most at-risk group (83.3%). The children, adolescents, youths were marked at low to moderate (45.1%-62.2%) risk of COVID-19. Regional, township, and access to communication showed significant variations in myths, false assurances, and information needs (p <0.05).

CONCLUSIONS

Considering young population as being at low risk of COVID-19 would be challenging to the control efforts, and needs special attention. Risk communication and community engagement efforts should consider regional and township variations of myths and false assurances. It should also need to satisfy information needs, design local initiatives that enhance community ownership of the control of the virus, and thereby support engagement in standard precautionary measures. All forms of media should be properly used and regulated to disseminate credible information while filtering out myths and falsehoods.

Using Social Media to Communicate Sustainable Preventive Measures and Curtail Misinformation

Effective crisis and risk communication strategies are crucial to promote preventive measures, particularly during times of emergency such as the global SARS-CoV-2 (COVID-19) pandemic. With its global reach, social media is a key source of news and information about COVID-19. However, the abundance of misinformation about personal protective measures that people post on social media, makes it imperative to develop a deeper understanding of effective messaging strategies. Improving the quality of information and strategy with which it is disseminated through social media is crucial to minimizing anxiety, panic and improving the adoption of sustainable preventive measures in addition to curtailing misinformation. Understanding the components of effective health communication strategies allows us to glean common methods to address misinformation which in turn lead to people adopting the appropriate preventive measures. The purpose of this article is to understand how effective social media communication strategies can be crafted to promote sustainable preventive measures and curtail wide-spread misinformation. Health organizations as well as communications organizations have made available information for effective social media messaging and more importantly serve as a gateway to other resources. We review their recommendations to identify common social media communication elements on the adoption of sustainable preventive measures and effective strategies for curtailing misinformation. We further review social media messaging during the Ebola and Zika outbreaks to evaluate the success of social media strategies and draw from lessons learned. We then create a set of best practices for developing and disseminating social media messaging regarding COVID-19.

Countering misinformation via WhatsApp: Preliminary evidence from the COVID-19 pandemic in Zimbabwe

We examine how information from trusted social media sources can shape knowledge and behavior when misinformation and mistrust are widespread. In the context of the COVID-19 pandemic in Zimbabwe, we partnered with a trusted civil society organization to randomize the timing of the dissemination of messages aimed at targeting misinformation about the virus to 27,000 newsletter WhatsApp subscribers. We examine how exposure to these messages affects individuals' beliefs about how to deal with the virus and preventative behavior. In a survey of 864 survey respondents, we find a 0.26σ increase in knowledge about COVID-19 as measured by responses to factual questions. Through a list experiment embedded in the survey, we further find that potentially harmful behavior-not abiding by lockdown guidelines-decreased by 30 percentage points. The results show that social media messaging from trusted sources may have substantively large effects not only on individuals' knowledge but also ultimately on related behavior.

Beyond the Pathogen: Social and Behavioral Aspects of COVID-19

COVID-19 presents an existential challenge for millions of people and a generational challenge for the globe. Scientific research is the primary vehicle in humanity's attempts to understand the virus and mitigate its effects. Research on the pathogen is critically important. At the same time, COVID-19's consequences are due to more than the pathogen. Social and behavioral science research is essential in understanding how to achieve the highest possible health and safety levels, and how to preserve and improve quality of life, within complex and interdependent societies. This article describes the social sciences' role in this challenge and offers examples of its insights.

Misinformation and the US Ebola communication crisis: analyzing the veracity and content of social media messages related to a fear-inducing infectious disease outbreak

Background

The Ebola communication crisis of 2014 generated widespread fear and attention among Western news media, social media users, and members of the United States (US) public. Health communicators need more information on misinformation and the social media environment during a fear-inducing disease outbreak to improve communication practices. The purpose of this study was to describe the content of Ebola-related tweets with a specific focus on misinformation, political content, health related content, risk framing, and rumors.

Methods

We examined tweets from a random 1% sample of all tweets published September 30th - October 30th, 2014, filtered for English-language tweets mentioning “Ebola” in the content or hashtag, that had at least 1 retweet (N = 72,775 tweets). A randomly selected subset of 3639 (5%) tweets were evaluated for inclusion. We analyzed the 3113 tweets that meet inclusion criteria using public health trained human coders to assess tweet characteristics (joke, opinion, discord), veracity (true, false, partially false), political context, risk frame, health context, Ebola specific messages, and rumors. We assessed the proportion of tweets with specific content using descriptive statistics and chi-squared tests.

Results

Of non-joke tweets, 10% of Ebola-related tweets contained false or partially false information. Twenty-five percent were related to politics, 28% contained content that provoked reader response or promoted discord, 42% contained risk elevating messages and 72% were related to health. The most frequent rumor mentioned focused on government conspiracy. When comparing tweets with true information to tweets with misinformation, a greater percentage of tweets with misinformation were political in nature (36% vs 15%) and contained discord-inducing statements (45% vs 10%). Discord-inducing statements and political messages were both significantly more common in tweets containing misinformation compared with those without(p < 0.001).

Conclusions

Results highlight the importance of anticipating politicization of disease outbreaks, and the need for policy makers and social media companies to build partnerships and develop response frameworks in advance of an event. While each public health event is different, our findings provide insight into the possible social media environment during a future epidemic and could help optimize potential public health communication strategies.