Preparing Public Health Educators to Work in a World of Mis and Dis Information

The proliferation of misinformation and disinformation in the field of public health presents a significant challenge for educators and public health practitioners alike. It is essential that we develop effective strategies and pedagogy for teaching about these issues to ensure that public health messaging is accurate, evidence-based, and trusted by the public. This will contribute to healthier, more informed individuals, communities, and a global society.

False narratives about public health topics and issues are disseminated on a regular basis, in direct contradiction of prevailing scientific conclusions from evidence-based studies. Whether the false narrative is labeled as misinformation (i.e., false information spread unintentionally) or disinformation (i.e., false information spread with malicious intent; Starbird, 2019), both types have had a negative impact on public health efforts. Mis/Dis information assaults against COVID-19 prevention and control activities, routine childhood immunization campaigns, and issues as diverse as climate change, social injustices against marginalized groups, and sexual and reproductive health have disrupted and impaired the effectiveness of our scientifically driven and evidence-based approach for message delivery within sociological contexts (Brangham, 2022; CCDH, 2023). As public health education specialists, we acknowledge that the global technological and information-rich communication setting is both exhilarating and terrifying with the potential to advance positive health behaviors and disrupt negative disease outcomes. However, with the pervasiveness of social media, there is a pressing need to explore pedagogical strategies that address ways to counter the negative impacts and reap the potential benefits of easily accessible health information (Bin Naeem & Kamel Boulos, 2021; Wang et al., 2022).

The media have always played an outsized role in how health information is covered, but for the most part, health professionals assumed that the general public would accept the recommendations from the scientific community reported by reputable media and governmental sources, public health and medical organizations, and their respective peer-reviewed journals (Centers for Disease Control and Prevention [CDC], 2021). Federal health agencies, despite their traditional nonpartisan stances, are now accused of being influenced by whomever is at the helm, and political divisions have only exacerbated the mistrust of information emanating from those sources (Dawes & Williams, 2020). Public health education specialists must revisit our approach to public health messaging in a world where the spread of disinformation has led to increased resistance to proven public health guidelines, such as wearing masks and getting vaccinated (Kouzy et al., 2020). Successful information campaigns of the past, to reduce tobacco use and mitigate the spread of HIV need to be reexamined to identify pedagogical tools better suited for the new media environment.

Younger generations seem more prepared to engage with the new information landscape. But, to what extent does familiarity with these tools risk their ability to distinguish what is real and what is not? How can public health education scholars best prepare students, early career and other more experienced professionals, to discern fact from fiction? Early et al. (2021) found that college students felt very confident using digital technology to find health information, but significantly less confident in discerning credible versus suspect sources online. Students also struggled with summarizing assignment material when there was extensive description and elaboration of false information in an online context (Greer et al., 2022). Swire-Thompson and Lazer (2020) suggested that students relied on superficial cues such as the visual design of the website or the popularity of the source. Such cues can be easily manipulated by those with malicious intent, thereby perpetuating false information. It is therefore important to teach students to look beyond these superficial cues and critically evaluate the content they come across. Allington et al. (2020) concluded that false information regarding the pandemic, including conspiracy theories and misinformation about treatments, was widely shared on social media. This underscores the importance of equipping students with the skills to evaluate the credibility of sources for use in their personal and professional lives (Allington et al., 2020).

Worldwide initiatives to address these concerns include those led by UNICEF, Yale Institute for Global Health, and The Public Good Projects (PGP) who have partnered to create manuals and national training sessions for public health agencies (“Countering Truth Decay,” 2018; “Vaccine Misinformation Management Field Guide,” n.d.). Strategies promoting “social listening” (CDC, 2021) and software to conduct media monitoring are being used to catch misinformation early and address them in a timely fashion. The field of Info-epidemiology is in its infancy (PHCC, 2023), and WHO’s focus on developing tools to manage the “infodemic” (Zarocostas, 2020) of misinformation are both relevant terms to address these issues. New platforms and partnerships with selected and vetted content creators are training responders to counter misleading claims and falsehoods.

Other important actors are seeking to address a related issue of online hate and disinformation by creating safer digital environments for youth and adults, providing resources and trainings for parents, educators, employers, and guidance to higher education institutions (The White House, 2022). Global conferences are being convened to discuss ways to stop misinformation from eroding public trust in science, scientists, and the institutions they serve (Nobel Prize Summit, n.d.). The take home messages from these important actors suggest that those who work and teach in public health cannot afford to wait for misinformation to slow down. Rather, we need to actively engage and counter efforts that may negatively impact the public’s mental and physical health.

Lawmakers in many countries have tried to deal with misinformation campaigns online but questions arise as to their limited ability to keep pace with the proliferation of lies and inaccuracies, and whether or not there are tradeoffs to clamping down on what some may consider as political speech (Yadav et al., 2021). Despite corporate and legislative efforts to contain misinformation (Brangham, 2022), recently passed bipartisan legislation in the U.S. to expand online connectivity to remote and distant locations, are expected to further complicate efforts to slow its pace. Moreover, recent federal rulings restricting the government from communicating with social media platforms about content online will likely make it harder to combat mis/disinformation in the future (Myers & McCabe, 2023).

One thing is certain, the misinformation will not stop. It is too profitable, too intoxicating, and too powerful an incentive for those who want to disrupt (CCDH, 2023). The omnipresence of social media, and the latest computer-generated technological tools using Artificial Intelligence (AI), ChatGPT, and the Metaverse are advancing at speeds greater than our capacity to respond effectively as noted by even the leaders in the technology field (Metz & Schmidt, 2023). Furthermore, public health practitioners’ ability to teach how to discern factual from false information will be complicated by the need to bridge the technological generational divide, expand broadband access, build digital skills, improve digital literacy, and rebuild trust in medical and public health institutions.

As practitioners and scholars, we require new pedagogical tools that will help us build capacity to counter the confusion and sense of helplessness that many of us feel in the face of information coming to us through a variety of channels and settings. Promising practices include the development of a “Disinformation Detox” syllabus that aims to teach undergraduates how to study and use systematic approaches to analyze and navigate information sources (Paris et al., 2022) or exercises that promote media literacy (Vamanu & Zak, 2022) or online fact checking skills (Brodsky et al., 2021, McGrew & Chinoy, 2022). No single communication, behavioral, or social science theory will suffice. Our interventions must be repetitive, targeted, multi-faceted, and overlapping (Bode & Vraga, 2021). At the same time, we need to reestablish basic public health education lessons to rely on outreach and partnerships with local health departments and community leaders as trusted voices. We must focus on training public health educators to be “high touch” not just “high tech” (PHCC, 2023). We are only as powerful as the audiences that we seek to empower.

The proliferation of misinformation and disinformation in the field of public health presents a significant challenge for educators and public health practitioners alike. It is essential that we develop effective strategies and pedagogy for teaching about these issues to ensure that public health messaging is accurate, evidence-based, and trusted by the public. By investing in research on effective strategies and pedagogy for teaching about misinformation and disinformation in public health and working also at the local level to partner on these issues, we can ensure that public health messaging is accurate, trustworthy, and culturally relevant. This will contribute to healthier, more informed and engaged students, who are prepared to engage effectively with communities in a rapidly changing global society.