The "Loci" of Misinformation and Its Correction in Peer- and Expert-Led Online Communities for Mental Health: Content Analysis

Clusters of Patient Empowerment and Mental Health Literacy Differentiate Professional Help-Seeking Attitudes in Online Mental Health Communities Users

OBJECTIVES

Grounded in the Health Empowerment Model, which posits that health literacy and patient empowerment are intertwined yet distinct constructs, this study investigates how the interplay of these factors influences attitudes toward seeking professional psychological help in members of online communities for mental health (OCMHs). This while acknowledging the multidimensionality of patient empowerment, encompassing meaningfulness, competence, self-determination, and impact.

DESIGN AND METHODS

A cluster analysis of data gathered from 269 members of Italian-speaking OCMHs on Facebook has been performed.

RESULTS

Four profiles have been identified: dangerous self-managers (11.2%), effective self-managers (21.2%), disempowered (40.5%) and ambivalent empowered (27.1%). Clusters provided meaningful variations in help-seeking attitudes, also when controlling for depression and anxiety severity, F3, 265 = 11.910, p < 0.001.

CONCLUSIONS

The findings provided further evidence of the multidimensionality of patient empowerment. Considering the results, we discussed potential interventions aimed at enhancing the quality of OCMHs, tailoring to the unique characteristics of each cluster.

PATIENT OR PUBLIC CONTRIBUTION

Administrators and moderators of mental health Facebook communities-whether expert-led by mental health professionals or peers-played a key role in this study. They provided valuable insights during the questionnaire design process to ensure the questions were both relevant and appropriate for community members. These administrators and moderators also actively facilitated participant recruitment by creating and sharing posts, either video- or text-based, on community homepages. Furthermore, after completing the questionnaire, participants were encouraged to comment on the Facebook posts where the survey link was shared, mentioning that they participated and inviting other members to take part. This approach aimed to foster a sense of involvement and further promoted the survey within the community.

Predicting User Engagement in Health Misinformation Correction on Social Media Platforms in Taiwan: Content Analysis and Text Mining Study

BACKGROUND

Health misinformation undermines responses to health crises, with social media amplifying the issue. Although organizations work to correct misinformation, challenges persist due to reasons such as the difficulty of effectively sharing corrections and information being overwhelming. At the same time, social media offers valuable interactive data, enabling researchers to analyze user engagement with health misinformation corrections and refine content design strategies.

OBJECTIVE

This study aimed to identify the attributes of correction posts and user engagement and investigate (1) the trend of user engagement with health misinformation correction during 3 years of the COVID-19 pandemic; (2) the relationship between post attributes and user engagement in sharing and reactions; and (3) the content generated by user comments serving as additional information attached to the post, affecting user engagement in sharing and reactions.

METHODS

Data were collected from the Facebook pages of a fact-checking organization and a health agency from January 2020 to December 2022. A total of 1424 posts and 67,378 corresponding comments were analyzed. The posts were manually annotated by developing a research framework based on the fuzzy-trace theory, categorizing information into "gist" and "verbatim" representations. Three types of gist representations were examined: risk (risks associated with misinformation), awareness (awareness of misinformation), and value (value in health promotion). Furthermore, 3 types of verbatim representations were identified: numeric (numeric and statistical bases for correction), authority (authority from experts, scholars, or institutions), and facts (facts with varying levels of detail). The basic metrics of user engagement included shares, reactions, and comments as the primary dependent variables. Moreover, this study examined user comments and classified engagement as cognitive (knowledge-based, critical, and bias-based) or emotional (positive, negative, and neutral). Statistical analyses were performed to explore the impact of post attributes on user engagement.

RESULTS

On the basis of the results of the regression analysis, risk (β=.07; P=.001), awareness (β=.09; P<.001), and facts (β=.14; P<.001) predicted higher shares; awareness (β=.07; P=.001) and facts (β=.24; P<.001) increased reactions; and awareness (β=.06; P=.005), numeric representations (β=.06; P=.02), and facts (β=.19; P<.001) increased comments. All 3 gist representations significantly predicted shares (risk: β=.08; P<.001, awareness: β=.08; P<.001, and value: β=.06; P<.001) and reactions (risk: β=.04; P=.007, awareness: β=.06; P<.001, and value: β=.05; P<.001) when considering comment content. In addition, comments with bias-based engagement (β=-.11; P=.001) negatively predicted shares. Generally, posts providing gist attributes, especially awareness of misinformation, were beneficial for user engagement in misinformation correction.

CONCLUSIONS

This study enriches the theoretical understanding of the relationship between post attributes and user engagement within web-based communication efforts to correct health misinformation. These findings provide a foundation for designing more effective content approaches to combat misinformation and strengthen public health communication.

Buffering against exposure to mental health misinformation in online communities on Facebook: the interplay of depression literacy and expert moderation

BACKGROUND

The proliferation of health misinformation on social media is a growing public health concern. Online communities for mental health (OCMHs) are also considered an outlet for exposure to misinformation. This study explored the impact of the self-reported volume of exposure to mental health misinformation in misinformation agreement and the moderating effects of depression literacy and type of OCMHs participation (expert vs. peer-led).

METHODS

Participants (n = 403) were recruited in Italian-speaking OCMHs on Facebook. We conducted regression analyses using PROCESS macro (moderated moderation, Model 3). Measures included: the Depression Literacy Questionnaire (Griffiths et al., 2004), the self-reported misinformation exposure in the OCMHs (3 items), and misinformation agreement with the exposure items (3 items). Whether participants were members of expert or peer-led OCMHs was also investigated.

RESULTS

The final model explained the 12% variance in the agreement. There was a positive and significant relationship between misinformation exposure and misinformation agreement (β = 0.3221, p < .001), a significant two-way interaction between misinformation exposure and depression literacy (β = - 0.2179, p = .0014 ), and between self-reported misinformation exposure and type of OCMH (β = - 0.2322, p = .0254), such that at higher levels of depression literacy and in case of participation to expert-led OCMHs, the relationship misinformation exposure-misinformation agreement was weaker. Finally, a three-way interaction was found (β = 0.2497, p = .0144) that showed that depression literacy moderated the positive relationship between misinformation exposure and misinformation agreement such that the more misinformation participants were exposed to, the more they agreed with it unless they had higher levels of depression literacy; this, however, occurred only if they participated in peer-led groups.

CONCLUSIONS

Results provide evidence that the more members reported being exposed to mental health misinformation, the more they tended to agree with it, however this was only visible when participants had lower depression literacy and were participating in peer-led OCMHs. Results of this study suggest that both internal factors (i.e., high depression literacy) and external factors (the type of online community individuals were participating in) can buffer the negative effects of misinformation exposure. It also suggests that increasing depression literacy and expert community moderation could curb the negative consequences of misinformation exposure related to mental health. Results will guide interventions to mitigate the effects of misinformation in OCMHs, including encouraging health professionals in their administration and implementing health education programs.