The Urgent Need for Coordinated and Comprehensive Efforts to Combat Misinformation

¹Pro-Change Behavior Systems, Inc, South Kingstown, RI, USA

Misinformation is by no means a new topic. Documented efforts to misinform date back as far as 44 BC with a political smear campaign against Mark Antony carved on coins. Advances in communication technology, ranging from the invention of the printing press to the explosion of social media platforms, have accelerated the speed with which misinformation can travel and its global reach. ¹

Research has revealed numerous diverse contributors to our susceptibility to misinformation, including cognitive processing factors or reasoning styles; characteristics of the information and source; ease of consumption; political ideology; and demographic factors. ¹ Dr. Shurney elaborates on some of these factors later in this issue.

Misinformation about the COVID-19 pandemic has been rampant since the outset, ² particularly with regard to mask-wearing ¹ and vaccines.^1,3 In fact, the World Health Organization and other global health organizations ⁴ called on the world leaders and other stakeholders to take action to manage the parallel infodemic (ie, overabundance of information that includes incorrect information to undermine the public health response). The first Surgeon General’s Advisory issued during the Biden Administration was released by Dr. Vivek Murthy in July, 2021 to caution the American public about the urgent threat of health misinformation. ⁵ The Surgeon General warned that misinformation (ie, information that is false, inaccurate, or misleading based on the best evidence available) “can cause confusion, sow mistrust, and undermine public health efforts, including our ongoing work to end the COVID-19 pandemic.” ⁵

Misinformation has also led to the use of unproven – and potentially dangerous – treatments for COVID-19, including ivermectin, ⁶ an antiparasitic drug used to deworm animals. In addition to overdoses that required hospitalization in some cases, people’s use of this baseless treatment has caused a shortage of the drug for animals who need it. ⁷ Research has uncovered links between hundreds of deaths and thousands of hospitalizations globally and misinformation about other untested COVID-19 treatments. ⁸ Beyond the pandemic, misinformation also has very real and dire consequences in other areas, not the least of which is its potential to influence voting behavior and spur violence. ¹

Addressing the threat of misinformation will require coordinated and comprehensive efforts on the part of the media; health care providers and systems; government entities and policy makers; researchers; and educators to assist individuals, families, and communities in more easily recognizing it and limiting its spread.^1,5 In this issue, Dr. Lindsey Leininger and her esteemed co-authors outline the core communication principles their multidisciplinary team derived from the inspiring and successful social media public education campaign they launched in response to the infodemic.

Researchers have examined the effects of multiple types of other interventions to counter misinformation, including humor and emotion, ⁹ narratives, ¹⁰ and efforts to change mental representations in ways that are connected to values. ¹¹ In this issue, Drs. Roozenbeek and Van der Linden explain that the research on psychological interventions to combat the spread of misinformation has produced mixed results, a theme underscored by others. ¹² They eloquently capture the benefits and potential drawbacks of 3 psychological solutions and underscore the need to employ a range of solutions.

Much of the literature acknowledges that the impact of misinformation can persist even despite corrective actions. ¹² The Surgeon General also underscored the critical role technology and social media companies have in stemming the tidal wave of misinformation on their platforms. ⁵ These companies have numerous tools at their disposal to curtail misinformation, but the efforts will need to be evidence-based and carefully implemented to be effective. A recent review of misinformation interventions ¹³ reveals that many of the Americans who have been exposed to such interventions (eg, credibility labels, removal, downranking) fundamentally misunderstood how the interventions were being applied – 40% mistakenly believed that most or all content on online platforms is checked. The authors underscored the importance of clearly explaining the process behind interventions and re-evaluating how platforms operate (eg, additional external oversight). Despite promises to stem the tide of falsehoods about the coronavirus and vaccines, at least 1 whistleblower reported that Facebook is not capable of stopping misinformation. ¹⁴ It is important to note that there are differing levels of support for misinformation interventions by political party. ¹³

Another critical element in the battle against misinformation is building trust, ¹⁵ in part because trust in institutions is a predictor of support for misinformation interventions. ¹³ In their article, Calac and Southwell make a compelling case for the need to better integrate thinking about trust and organizational relationships into the emerging scholarship on misinformation. The importance of trust is further highlighted in the final article in this issue by Mr. Udoh, who explains that mistrust for authority is a major contributor to vaccine hesitancy in South Sudan and shares the success Angola has had using trusted volunteer community mobilisers to address vaccine hesitancy related to stigma and misinformation at the community level. In a previous paper, Southwell et al ¹⁵ emphasized that patients must feel empowered to raise concerns or ideas – even if they are concerned that the health care provider with whom they are interacting will perceive their idea to be controversial. They recommended that health care providers invite and encourage patients to engage in a dialogue about topics rife with misinformation by utilizing open-ended questions to assess what patients have already heard or learned about that topic.

In addition to those suggestions, Dr. Shurney provides several practical tips about how employers can address misinformation within their organizations.

“The misinformation crisis exemplified and intensified by the COVID-19 pandemic lays a gauntlet at the door of all science communicators.” ¹²

The disturbing pervasiveness and wide-reaching impacts of misinformation are indicative that combatting it will indeed require a coordinated global effort. ¹ In addition to the insights the contributors to this issue have shared, additional resources and tools can be found on the following sites:

• A Community Toolkit for Addressing Misinformation from the Office of the Surgeon General https://www.hhs.gov/sites/default/files/health-misinformation-toolkit-english.pdf