This talk invites health education and health promotion professionals to reflect on their evolving role in the age of digital complexity. As digital spaces increasingly shape how people seek, share, and understand health information, educators must expand their impact beyond individuals and communities. We’ll explore how your work also needs to reach upward to senior leaders and policymakers, across to peers in communication, tech, and healthcare, and downward to support and guide newer professionals entering the field. Drawing on SOPHE competencies, this presentation emphasizes relational communication, trust-building, participatory strategies, and systems thinking as essential tools for navigating information ecosystems that are fragmented, commercialized, and emotionally charged. We’ll look at real-world examples—from reproductive health apps and social media self-diagnosis to AI-generated health content—and consider what it takes to build resilience, credibility, and connection in this new environment. Health educators are not just communicators; we are system influencers in a digital world.

1. NAVIGATING DIGITAL
COMPLEXITY
INFORMATION ECOSYSTEMS AND
HEALTH EDUCATION IN 21ST CENTURY
Tina D Purnat, TH Chan School of Public Health, Harvard University
tinapurnat.com

2. This presentation (c) 2025 by Tina D Purnat is
licensed under Attribution-NonCommercial-
ShareAlike 4.0 International

3. Trust is more fragmented and declining for traditional institutions
Source: https://www.kff.org/health-information-and-trust/poll-finding/kff-tracking-poll-on-health-information-and-trust-january-2025/#:~:text=key%20health%20positions%2C%20the%20latest,great%20deal
%E2%80%9D%20or%20%E2%80%9Ca%20fair

4. Who is authoritative to speak about health has
shifted.
Source: https://condenaststore.com/featured/these-smug-pilots-have-lost-touch-with-regular-will-mcphail.html?srsltid=AfmBOopjgW98feBY2rHwNE5i6qS5rvLcN4ZJ-p9RYUAlf-aVIHhfDGvF

5. U.S. adults reported that they had gone online
to research a health problem in the past year
2013: 58%
Americans who will Google their health concern
before contacting a medical professional
2019: 89%
Where people seek answers has shifted dramatically
source: https://www.empr.com/home/features/do-your-patients-consult-google-before-they-consult-you-an-expert-interview-with-james-a-elizy-md/#:~:text=Project%20as%20%E2%80%9Conline%20diagnosers.
%E2%80%9D
https://ahimafoundation.ahima.org/media/215h2p3w/ahima_newsworthyanalysis_10-11.pdf
https://www.kff.org/health-information-and-trust/poll-finding/kff-health-misinformation-tracking-poll-artificial-intelligence-and-health-information/
Americans who research their doctor’s
recommendations after an appointment
42%
US young people 18-29 who use Ai chatbots at least
onece per month for health information and advice
2024: 25%

6. Source:
https://www.pbs.org/newshour/classroom/daily-news-lessons/2024/10/hurricane-recovery-complicated-by-conspiracy-theories
https://www.cbsnews.com/amp/news/measles-mmr-vaccine-myths/
https://theweek.com/culture-life/food-drink/the-myth-of-healthy-moderate-drinking
https://www.nbcnews.com/health/health-news/influencers-claim-beef-tallow-health-beauty-benefits-not-necessarily-e-rcna195206

7. Information ecosystems contain questions, concerns,
information voids, misinformation and disinformation
Questions Concerns Information
voids
Misinformation Disinformation
PREVENTIVE action REACTIVE action
See: Managing Infodemics in the 21st Century: https://link.springer.com/book/10.1007/978-3-031-27789-4

8. • misinformation “on
demand”
• overreliance on low-
quality apps as a source of
medical information
• difficulties assessing
mobile app credibility and
reliability
• data privacy concerns
Source: https://www.latimes.com/california/story/2022-07-16/fertility-apps-community
https://www.thelantern.com/2025/02/ohio-state-researchers-find-increase-in-fertility-app-use-post-dobbs-decision-despite-privacy-concerns/
https://www.lshtm.ac.uk/newsevents/news/2024/industry-funded-alcohol-reduction-apps-contain-misinformation-study-warns
https://www.scientificamerican.com/article/how-sports-betting-apps-use-psychology-to-keep-users-gambling/

9. Online health
information seeking
is gendered...
and so is
deceptive marketing.
Source:
https://www.theguardian.com/australia-news/2024/feb/15/companies-marketing-useless-health-products-to-women-using-feminist-wellbeing-messages
https://www.jwatch.org/na56027/2023/04/13/commercial-mens-health-clinics-often-provide-questionable
https://www.theguardian.com/society/2025/feb/27/social-media-influencers-are-fearmongering-to-promote-health-tests-with-limited-evidence-study-finds
https://www.smh.com.au/lifestyle/health-and-wellness/the-tiktok-trend-encouraging-teen-boys-to-get-fit-try-steroids-and-starve-themselves-20241010-p5kh7j.html

10. Poorly moderated
online spaces and
user-made AI bots
are competing
against health
promotion efforts
and health services.
Source:
https://cyberscoop.com/graphika-ai-chatbots-harmful-behavior-character-ai/
https://www.nbcpalmsprings.com/2025/04/01/apa-warns-ai-chatbots-are-masquerading-as-mental-health-professionals
https://www.parents.com/new-analysis-shows-tiktok-adhd-misinformation-problem-11704397
https://news.ku.edu/news/article/study-finds-people-prefer-ai-chatbots-when-discussing-embarrassing-health-info-but-humans-when-they-are-angry
https://theconversation.com/metas-shift-to-community-notes-risks-hurting-online-health-info-providers-more-than-ever-247331

11. Navigating Digital Complexity: Roles for Health Education
• information navigation, relational
communication and being present in
community conversations
• translating and filtering information in a
way that makes sense locally and
personally
• carrying community feedback upward to
health authorities
• building media, science, digital, and
health literacy
• addressing real-world information needs
and filling voids
https://www.sophe.org/seven-areas-responsibility-health-education-specialists/

12. Navigating Digital Complexity: Skills and Tools from Health
Education
• methodical approach to digital health
education, engagement and communication
• apply community planning models to
expanded understanding of what is a
community and where people seek it online
• understand underlying values and needs that
drive how people understand health
information, not merely the factfulness
• transfer participatory evaluation approaches
to understand how community heath is
affected by online information ecosystems
and whether interventions do what we
assume they do
https://www.sophe.org/seven-areas-responsibility-health-education-specialists/

13. Share your tools and offer
your skills to help others
understand community and
human-centered
approaches.
They’re essential for
effectively addressing the
challenges of the digital
information ecosystem.

14. Unless credited, images generated by ChatGPT 4o.
https://bit.ly/lionstigersohmy

15. Thank you very
much!
tinapurnat@hsph.harvard.edu
https://dot.cards/tdpurnat

16. Source: https://www.kff.org/health-information-and-trust/poll-finding/kff-
tracking-poll-on-health-information-and-trust-january-2025/#:~:text=key
%20health%20positions%2C%20the%20latest,great%20deal%E2%80%9D%20or
%20%E2%80%9Ca%20fair

17. Source: AHIMA foundaiton, https://ahimafoundation.ahima.org/media/215h2p3w/ahima_newsworthyanalysis_10-11.pdf