Study identifies strategies to address health misinformation online

Health care professionals use four strategies to counteract health misinformation on social media platforms, according to a study presented at Association for Healthcare Social Media Meeting.

John Robert Bautista, RN, MPH, PhD, Bullard Research Fellow at the University of Texas at Austin, said during the presentation that although papers have previously been published to encourage health care professionals to address health misinformation online, they have not explained how physicians should do this.

“Recently, the WHO introduced the term ‘digital first responders’ ... internet or social media users that can share correct information about COVID-19 as a means to counter misinformation about it,” Bautista said, adding that there has not yet been a study on how health care professionals actually should counter health misinformation.

To evaluate how health care professionals address misinformation, Bautista conducted in-depth semi-structured interviews with 15 medical doctors and 15 registered nurses in the United States between January and March 2020.

Participants were recruited through purposive and snowball sampling, and interviews were conducted over the phone. Transcripts were then analyzed in NVivo 12 with a phenomenological method of thematic analysis.

Most participants used Twitter and Facebook, with some using Instagram, Pinterest, LinkedIn, TikTok, Doximity and Snapchat. Most social media platforms were used for professional purposes, but some — including Facebook, Instagram and Snapchat — were used for personal purposes or entertainment.

Bautista identified four strategies health care professionals used to counteract health misinformation that were based on four factors: means of correction, audience engagement, risk for confrontation and social ties.

The first strategy — public rebuttal — involved responding to misinformation posts by publicly pointing out misinformation and rebutting by including links to credible sources or evidence-based information. Bautista said this was an active means of correction because it involved directly rebutting misinformation, and had high audience engagement and risk for confrontation because it is viewed publicly and can result in responses from unknown or anonymous people.

Private rebuttal — the second strategy — involved health care professionals responding to misinformation posts by privately pointing out the misinformation and sending credible information as a rebuttal to the person who posted the misinformation. He explained that this strategy is an active means of correction with low audience engagement because it is only sent to one person. However, the risk for confrontation is strong, and there are typically strong social ties because the health care professional usually knows the individual they are rebutting.

Public priming, another strategy identified by Bautista, involved publicly posting or sharing information from a credible source to prime other users against health misinformation. The strategy was considered a passive means of correction as it does not involve directly addressing misinformation, but has high audience engagement because it can be viewed publicly. It was also considered to have a low risk for confrontation and weak social ties, because the intended audience included individuals who may be unknown to the poster.

Private priming — the fourth method— involved health care professionals privately posting or sharing factual information to prime others against misinformation. Bautista considered it to be a passive means of communication because misinformation was not directly addressed in a rebuttal, and it results in low audience engagement because it cannot be publicly viewed. Additionally, the risk of confrontation is low using this method, and it is associated with strong social ties because the audience is known to the poster.

Based on his interviews, Bautista said that health care professionals are likely to use public priming and public rebuttal as their methods of addressing health misinformation.

“We know that health care professionals are highly qualified as digital first responders to counteract health misinformation on social media,” Bautista said.

“Between priming and rebuttal, priming is a much softer approach,” he said, adding that rebuttal is a more active and direct approach to health misinformation and can lead to confrontation.

Therefore, Bautista said health care professionals who are not comfortable with engaging in rebuttal on social media can use a priming method to address misinformation.

Bautista said additional research is needed to determine the prevalence of use for each strategy among health care professionals, and to “determine what type of counteracting mechanism would be effective to reduce belief in misinformation among the public.”