Combating Misinformation _ Penn State.pptx
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The grand rounds lecture, "Combating Health Misinformation" was delivered by Dr. Michael Gisondi to Penn State Emergency Medicine on June 1, 2022. The talk covered methods for addressing health misinformation in clinical spaces and on social media.
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Combating Misinformation _ Penn State.pptx
- 1. M I C H AE L A. G I S O N D I , M D V I C E C H AI R O F E D U C AT I O N D E PAR T M E N T O F E M E R G E N C Y M E D I C I N E S TAN F O R D S C H O O L O F M E D I C I N E COMBATING HEALTH MISINFORMATION
- 2. @MikeGisondi Penn State Emergency Medicine Grand Rounds - June 1, 2022 I have no pertinent disclosures to report, financial or otherwise. My political views are not endorsed by Stanford University.
- 3. 3 Questions to Answer: What is the impact of health misinformation? What are best practices for addressing misinformation with patients? How can we leverage social media to combat health misinformation?
- 9. Prolongs Pandemic New Variants Vaccine Fatigue Affects Mental Health
- 12. INFODEMIC: TOO MUCH INFORMATION… (1) confusion (2) mistrust (3) lengthens outbreaks WHO
- 15. How can you and your residency program combat health misinformation?
- 18. Spend Time with Patients Deliberating Vaccines
- 20. Spend Time with Patients Deliberating Vaccines “Have you received other vaccines?” “May I ask why not the COVID vaccine?”
- 21. Engage Patients With Empathy “I understand why you’re concerned.” “May I share some information with you?” “Thank you for letting me share what I know.”
- 22. Personalize the Message “Let’s focus on how the vaccine can help you.” “You’re healthy, yet COVID can still make you sick.” “The vaccine can prevent you from getting seriously sick.” “You won’t need to worry as much.”
- 23. Describe How Misinformation Happens “I understand your worry about vaccine side effects.” “The vaccine has been safely administered to half of the world.” “Inevitably some will get sick from another illness.” “It doesn’t mean the vaccine caused them to get sick.”
- 24. Use Learner-Centered Educational Frameworks Safe learning environments Internal Learner Motivation Scaffolding and Framing Social Acceptability Sheng et al. AEM ET. 2021
- 25. 6-Step Myth Debunking Strategy 1. State the misinformation once. 2. Immediately state a fact. 3. Explain why the fallacy was once considered true. 4. Explain why we know it to be false. 5. Explain why the alternative is correct. 6. Close by stating the fact again.
- 26. 6-Step Myth Debunking Strategy 1. The vaccine was made too quickly and its unsafe. 2. The vaccine is among the safest ever made. 3. Some worried that vaccine testing was rushed. 4. Vaccine was tested in an appropriately large population. 5. It has since been given safely to half the world. 6. The vaccine is among the safest ever made.
- 27. Practice Motivational Interviewing: Respectful Dialogue Listen and Validate Provide Facts Patient Draws Conclusions
- 30. Celebrities on Social Media 70% of Attention 20% of Misinformation
- 32. Healthcare Provider Social Media Hesitancy Physicians not using their platform = Public health threat
- 33. Common Barriers to Social Media Engagement Lack of measurable outcomes Harassment and bullying Lack of institutional support Lack of social media training
- 34. Facilitators of Social Media Engagement Misinformation training Social media training Building social media presence
- 36. 5-Step Method to Combat Misinformation Online 1. Identify and Label Misinformation 2. Provide Correct Information 3. Reference a Source 4. Repeat the Correct Information 5. Respond Immediately
- 37. Things that might happen after a COVID-19 vaccine
- 40. A Stanford Conference on Social Media and COVID-19 Misinformation Stanfordinfodemic.org August 26, 2021
- 41. INFODEMIC: TOO MUCH INFORMATION… (1) confusion (2) mistrust (3) lengthens outbreaks WHO
- 42. The COVID-19 INFODEMIC: COMPLEX and CONTRADICTORY INFORMATION… (1) origins of the virus (2) treatment options (3) lifesaving vaccines Gisondi et al. JMIR. 2022
- 45. Engage patients online Create partnerships with social media companies and influencers
- 48. Engage in public health education online Use social media to connect to new strategic partners
- 49. Use Your Societal Platform: Engage in Social Media Identify Misinformation Provide Facts Partner with Stakeholders
- 51. ("social media" [tw] OR "social media" [mesh] OR twitter [ti] OR Instagram [ti] OR facebook [ti]) AND ("covid 19" [tw] OR covid [tw] OR covid19 [tw] OR "ncov 2019" [tw] OR "novel coronavirus" [tw] OR "sars cov 2" [tw] OR "sars cov-2" [tw] OR "ncov 2019" [tw] OR sarscov2 [tw] OR (wuhan [tw] AND coronavirus* [tw]) OR "corona virus*" [tw] OR "coronavirus disease 2019" [tw] OR "coronavirus disease 19" [tw] OR "2019 ncov" [tw] OR 2019nCoV [tw] OR "coronavirus 2" [tw] OR "Coronavirus"[Mesh:NoExp] OR "SARS-CoV-2"[Mesh] OR "COVID-19 Testing"[Mesh] OR "COVID-19" [mesh] OR "COVID-19 Vaccines"[Mesh] OR "Receptors, Coronavirus"[Mesh] OR "Spike Glycoprotein, Coronavirus"[Mesh] OR "SARS-CoV-2 variants" [Supplementary Concept]) AND ("Patient Education as Topic"[Mesh] OR "Patient Education Handout" [Publication Type] OR "health literacy" [tw] OR "patient education" [tw] OR "Health Literacy"[Mesh] OR "Health Promotion"[Mesh])
- 53. 3 Published Projects Residency Programs Educating the Public Online
- 54. Residents launched an awareness campaign about health inequities on Twitter
- 56. Residents filmed 60 TikToks about COVID 600,000 views
- 57. Residents made health infographics, videos in Chinese WeChat group of 500 patients
- 60. Educators and Educational Institutions Evidence-based Educational Programs Information Literacy Metrics
- 61. Health Professionals Healthcare Institutions Proactively Engage with the Public Use Technology to Share Information Partner with Community Groups
- 62. Researchers Research Institutions Assess the Impact of Misinformation Target Interventions to Communities Evaluate Interventions and Policies
- 63. Use Social Media in New Ways: Support social media use Develop new policies Teach best practices Find research opportunities
- 64. Surgeon General Murthy, 2021 “Limiting the spread of health misinformation is a moral and civic imperative that will require a whole-of-society effort.”
- 65. How can you and your residency program combat health misinformation?
Editor's Notes
- Thank you so much for having me
- Excited and honored to be here, Thank you especially to Dr Awar, Dr Mourad, and the Conference Planning Committee. I have no disclosures.
- But then 2020 happened, our patients died, we got sick, the moral injury happened…
- UNESCO: It is worth our time to talk about how we got here a bit before we can talk about next steps. I’ll define some terms along the way, and the first is Fake News. “Fake News” is a waste-basket term that includes all types of erroneous information, often communicated by respected individuals or the popular press.
- It became weaponized during the previous administration as a catch phrase of sorts, shortly following KellyAnne Conway’s appearance on Meet the Press early in the Trump presidency, in which she used the phrase alternative facts. By offering alternative facts in the face of actual facts, what constituted fake news was in the eye of the beholder.
- And in early 2020, at the start of the pandemic, when we knew very little about the virus, speculations, wild hypotheses, untested therapies, and misunderstandings about disease preventions all resulted in misinformation. Misinformation across multiple dimensions of the pandemic… the origin of the virus, its prevention, its treatment… each type of misinformation related but distinct. Distinct enough to convince people of several independent falsehoods, such that the correction of one fixed belief doesn’t necessarily mean that the others will or can be addressed. Lack of a cognitive reminder to check fact accuracy leads to spread
- This is especially problematic in certain populations in the US, especially in communities of color who may have a very well-founded distrust of health professionals, and fewer trusted individuals in their communities sharing accurate health information. This has led to health disparities with communities of color having lower vaccination rates than whites and correspondingly higher rates of serious illness and death.
- Vaccine hesitancy is different than the anti-vax movement. Anti-vaxxers refuse all vaccines including childhood vaccines. Vaccine hesitant individuals live in the middle of this continuum of vaccine acceptance, in which they may refuse or delay certain vaccines but not all vaccines. Misinformation clearly impacts vaccine hesitant people who believe seemingly believable information that they heard from a family member, or on a podcast, or at work, or at church. And these are trusted sources, so the information is therefore trusted. Even knowing that there are vaccine advocates and anti-vaxxers is enough to confuse and can prolong hesitancy.
- Whoever the vaccine hesitant are, and the reasons why they ae hesitant are important, but even more so is the duration of time in which they remain hesitant. The misinformation and the hesitancy gets ingrained over time and becomes harder and harder to address. So vaccination rates fall far short of where they should be, prolonging the pandemic, creating an environment in which new variants can emerge, and causes vaccine fatigue and covid fatigue, which challenge our health education efforts.
- And it all spills over, creeps over, to disinformation, which is erroneous information intentionally and deliberate spread out of malice. The 2020 campaign was full of disinformation from Russian trolls and domestic sources. And much of that disinformation related to covid and its impact on the outcome of the election.
- So finally, we find ourselves in an infodemic. Infodemic is the blending of the words information and epidemic, and it represents the problem of too much information, correct information, incorrect information, disinformation… all bubbling up together such that the accurate information is muted.
- The WHO offers a comprehensive and actionable definition of an infodemic…
- Infodemics have consequences for our individual patients, namely information overload, or analysis paralysis. It is the inability to comprehend when to much information is being presented, leading to an inability to make a logical decision. This has implications for how and why our patients are susceptible to misinformation and how we can address that. Stress-related complaints about COVID outpaced fear of COVID-19 in some studies.
- From a coronavirus.gov campaign, we can all agree with this statement. But how to get that sound advice to the people who need it most.
- Excited and honored to be here, Thank you especially to Dr Awar, Dr Mourad, and the Conference Planning Committee. I have no disclosures.
- I’d like to discuss three ways in which you can train your residents to combat health misinformation. How they act in the clinic, online, and as a residency program
- Let’s go to the clinic first, where I will give you 5 teaching tips
- Tip 1: Target the right audience, my residents would like to know where best to spend their time and effort
- Vaccine hesitancy is different than the anti-vax movement. Anti-vaxxers refuse all vaccines including childhood vaccines. Vaccine hesitant individuals live in the middle of this continuum of vaccine acceptance, in which they may refuse or delay certain vaccines but not all vaccines. Misinformation clearly impacts vaccine hesitant people who believe seemingly believable information that they heard from a family member, or on a podcast, or at work, or at church. And these are trusted sources, so the information is therefore trusted. Even knowing that there are vaccine advocates and anti-vaxxers is enough to confuse and can prolong hesitancy.
- How do you know if your patient is vaccine hesitant or a vaccine denier? Ask
- This brings us to Tip 2. Meet people where they are at. Approach these conversations from a place of partnership and empathy
- Tip 3 is to personalize the message. Initially, we thought that we could convince young healthy people to get vaccinated as a civic duty to protect their neighbors. This is an approach that was used by many religious leaders and politicians. Research now suggests that those who would be swayed by such arguments have likely already been vaccinated. Now it is time to personalize the message with you statements.
- Tip 4: Simply explain how misinformation happens. It is confusing for patients when they hear misinformation from otherwise trusted individuals and you can’t simply say “you’re wrong”… there needs to be some dialogue and explanation
- Before I close this section I would like to point out an interesting paper by Sheng et al in AEM Education and Training from last year in which they suggest that the clinical spaces in which we counsel patients should be treated like our classrooms, using known educational frameworks such as…
- The final teaching tip is a misinformation debunking strategy that has 6 steps
- So, when in the clinic, teach your residents to combat health misinformation using my motivational interviewing, the principles of which underpin my 5 teaching tips
- Now lets turn to combating health misinformation online
- So who’s to blame for misinformation? There are many fingers that can be pointed, but certainly social media companies are somewhat culpable. In one study, over half of all information considered misinformation originated on social media platforms. Misinformation is propagated online at lightning speeds, due in part to the search algorithms that push such content to certain users, trapping them in an information bubble where new content enters but no new ways of thinking or facts.
- And trusted individuals in our society, politicians, professional athletes, and celebrities are a huge source of misinformation. This is Joe Rogen, he has the number 1 podcast on Spotify, and he routinely has guests on his show that misinform his millions of listeners about the covid vaccine. Celebrities garner 70% of user attention on social media platforms and account for 20% of misinformation in our society. And they go unchecked by many platforms who live and die by user activity. If the users want to follow celebrities online, it isn’t in the best interests of social media companies to ban or censor them when they are discussing clear falsehoods about the virus or the vaccine.
- Many of you likely have concerns about engaging about these issues in the social media space…
- Like anything, the more training that you have, the more comfortable that you can become… today is the start of a conversation…
- Much like our 6 step debunking method for the clinic, there is a 5 step method for combating misinformation online
- Here is an example. This is the rapper Nicki Minaj, who has 24.4 million Twitter followers. She tweeted last fall, during the height of the public discourse on vaccines and hesitancy… Leave it to the Aussies, they responded immediately with…
- Tito’s vodka followed the formula. They included a source, offered an alternate explanation, repeated the correct information in two places in their tweet, responded immediately…
- Examples on Instagram from Stanford in the lead up to the INFODEMIC conference
- 2020 was a dark year for me and my students, we decided to do something more productive than simply rage tweet. We wrote a grant to an ethics foundation and they funded us to put a conference called INFODEMIC, last August, who went, why, etc. From this conference came two papers that I will share with you
- The WHO offers a comprehensive and actionable definition of an infodemic…
- My colleagues and I published an editorial earlier this year in which we define the covid-19 infodemic
- My colleagues and I published an editorial earlier this year in which we define the covid-19 infodemic
- My colleagues and I published an editorial earlier this year in which we define the covid-19 infodemic
- So to summarize my remarks about combating health misinformation online, I recommend you lean in and teach residents how to use their platform, or prepare them to do so responsibly when they leave your program. I’m not suggesting you send them out to go rouge, instead work with them as they experiment with a professional facing social media account
- Over 3 month period created appx 60 one minute Tiktoks based on new literature of the day and had 600,000 views
- Chicago, Chinese speaking community, WeChat, health resources
- A year later, in summer 2021, the scale of COVID misinformation was staggering, exploding from mistrust and distrust of health officials during vaccination campaigns. This led to our Surgeon General, Dr. Vivek Murthy (an internist by the way, who trained at the Brigham) to declare health misinformation a public health crisis. And by that time, about 8 months after the first vaccines were given, we knew a lot more about the US population, who was and wasn’t getting vaccinated, and misinformation in general. We know that misinformation directly affects vaccination rates by increasing vaccine hesitancy, leading to preventable deaths.
- GOAL: Target the right audience
- GOAL: Target the right audience
- GOAL: Target the right audience
- Excited and honored to be here, Thank you especially to Dr Awar, Dr Mourad, and the Conference Planning Committee. I have no disclosures.
- Excited and honored to be here, Thank you especially to Dr Awar, Dr Mourad, and the Conference Planning Committee. I have no disclosures.