Advancing Visual Health Communication Research to Improve Infodemic Response

Visual narratives in medicine - Bridging the gap in graphic medicine with an illustrated narrative of osteoarthritis

Objective

Visual narratives have been used in medicine to share information in the form of stories with the potential to improve understanding of conditions and change behaviours. One genre of visual narratives is "graphic medicine", which integrates comics into medical education and the delivery of healthcare. Graphic medicine can maximise the impact of research findings by presenting them in a more accessible format, which may be particularly useful in certain populations, such as those with low levels of health literacy. Those with lower health literacy levels and osteoarthritis (OA) are less likely to manage their condition with guideline recommended management strategies, experience a higher burden of disease, and have lower access to care. Our objectives were to review the current visual narratives in the field of and create a graphic medicine visual narrative based on existing research.

Design

This paper summarises the current visual narratives in OA and presents a graphic medicine visual narrative to illustrate the experience of living with OA. Considerations for the dissemination of visual narratives to target audiences are also discussed.

Results

The most common visual narratives in are infographics, videos, and graphic medicine. A graphic medicine visual narrative, based on previous qualitative work and informed by a framework, was created to illustrate two distinct narratives - impairment and participatory.

Conclusion

Visual narratives remain an emerging field in OA but may serve as a useful resource for patients or clinicians to discuss various aspects of OA management. Future research should evaluate and validate the use of visual narratives in OA.

How People Process Different Types of Health Misinformation: Roles of Content Falsity and Evidence Type

Emerging communication technologies have seen the proliferation of misleading claims, untruthful narratives, and conspiracies. To understand how people perceive and act on different types of misinformation, this study examines how health misinformation varying in falsity (fabrication versus misuse) and evidence type (statistical versus narrative) affects sharing and verification intentions. Using COVID-19 vaccines as cases, the results from an online experiment showed that misused misinformation was perceived as less false than fabricated misinformation and resulted in higher sharing intentions for the issue of vaccine efficacy. Misinformation with narrative evidence, as compared to that with statistical evidence, was perceived as less false and led to lower verification intentions. These findings can be explained by psychological processes such as counterarguing and narrative engagement. Our results can help practitioners develop dedicated misinformation literacy programs.

Understanding Mental Health Organizations' Instagram Through Visuals: A Content Analysis

This study analyzed the content, visual features, and audience engagement data of Instagram posts from two mental health organizations over one year (N = 725). For content features, mental health literacy and communicative strategies were examined. Posts that promoted knowledge of mental disorders and treatments, used information and community strategy were more likely to receive higher audience engagement. Visual features of demographic segments, visual composition, and visual framing topics were analyzed. Images that covered an unspecific population, used illustrated images, and focused on anti-stigma topical frames obtained more engagement. Theoretical contributions and practical applications regarding visual message design and management on social media to promote mental health are also offered.

Misinformed by images: How images influence perceptions of truth and what can be done about it

We organize image types by their substantive relationship with textual claims and discuss their impact on attention, comprehension, memory, and judgment. Photos do not need to be false (altered or generated) to mislead; real photos can create a slanted representation or be repurposed from different events. Even semantically related non-probative photos, merely inserted to attract eyeballs, can increase message acceptance through increased fluency. Messages with images receive more attention and reach a wider audience. Text-congruent images can scaffold the comprehension of true and false claims and support the formation of correct and false memories. Standard laboratory procedures may underestimate the impact of images in natural media contexts: by drawing all participants' attention to a message that may be ignored without an image, they inflate message effects in the control condition. Misleading images are difficult to identify and their influence often remains outside of awareness, making it hard to curb their influence through critical-thinking interventions. Current concerns about deep fakes may reduce trust in all images, potentially limiting their power to mislead as well as inform. More research is needed to understand how knowing that an image is misleading influences inferences, impressions, and judgments beyond immediate assessments of the image's credibility.

When Seeing Isn't Believing: Navigating Visual Health Misinformation through Library Instruction

Visual misinformation poses unique challenges to public health due to its potential for persuasiveness and rapid spread on social media. In this article, librarians at the University of Pittsburgh Health Sciences Library System identify four types of visual health misinformation: misleading graphs and charts, out of context visuals, image manipulation in scientific publications, and AI-generated images and videos. To educate our campus's health sciences audience and wider community on these topics, we have developed a range of instruction about visual health misinformation. We describe our strategies and provide suggestions for implementing visual misinformation programming for a variety of audiences.

A Scoping Review of Emerging COVID-19 Health Communication Research in Communication and Media Journals

This article reports a scoping review of emerging research on COVID-19 health communication. We reviewed and analyzed 206 articles published in 40 peer-reviewed communication journals between January 2020 to April 2021. Our review identified key study characteristics and overall themes and trends in this rapidly expanding field of research. Our review of health communication scholarship during the early stages of the COVID-19 pandemic suggests that health communication scholars have risen to the challenges and interrogated important issues in COVID-19 communication at the individual, group, organizational, and societal levels. We identified important gaps that warrant future research attention including experimental research that seeks to test the causal effects of communication, studies that evaluate communication interventions in under-served populations, research on mental health challenges imposed by the pandemic, and investigations on the promise of emerging communication technologies for supporting pandemic mitigation efforts.

How health organizations communicate about COVID-19 on social media: a comparative content analysis

BACKGROUND

This study examined how different health organizations (i.e., the Chinese CDC, the Korean CDC, the United States CDC, and WHO) communicated about the COVID-19 pandemic on social media, thus providing implications for organizations touse social media effectively in global health crises in the future.

METHODS

Three bilingual researchers conducted a content analysis ofsocial media posts (N = 1,343) of these health organizations on Twitter and Sina Weibo to explore the frames of the COVID-19 pandemic, the purposes, and the strategies to communicate about it.

RESULTS

Prevention was the dominant frame of the social media content of these four health organizations. Information update was the major communication purpose for WHO, the United States CDC, and the Korean CDC; however, guidance was the primary communication purpose for the Chinese CDC. The United States CDC, the Chinese CDC, and the Korean CDC heavily relied on multiple social media strategies (i.e., visual, hyperlink, and authority quotation) in their communication to the public about the COVID-19 pandemic, whereas WHO primarily employed quoting authorities. Significantdifferences were revealed across these health organizations in frames, communication purposes, and strategies. Theoretical and practical implications and limitations were discussed.

CONCLUSIONS

This study examined how different global health organizations communicate about the COVID-19 pandemic on social media. We discussed how and why these global health organizations communicate the COVID-19 pandemic, which would help health-related organizations design messages strategically on global public health issues in the future.

Health persuasion through emoji: How emoji interacted with information source to predict health behaviors in COVID-19 situation

By providing health information through visual communication, public health organizations can effectively guide and persuade people to adopt healthy behaviors, which is critical in the context of public health crises. In this study, drawing upon congruity theory and the premise of visual communication, we examined how information source and emoji may shape people's preventive and self-protective behaviors through perceived fear (PF) and perceived controllability (PC). Using a convenience sample of 210 participants, we conducted a 2 (emoji: with versus without) × 2 (information source: official versus unofficial) between-subject experiment. The results indicated that, compared with nonuse, the use of emoji in information resulted in higher PF, stronger preventive behavioral intention (PBI), and lower PC. In addition, a strong interaction effect was observed between emoji and the source of information on PBI. When emoji were added to health information released by an unofficial organization, the text outperformed that from an official agency in persuading people to adopt preventive behaviors. Furthermore, we determined that PF mediated the effect of emoji on PBI, but only for unofficial information sources. These results provide a reference for enhancing the effectiveness of health information including visual cues, such as emoji.

Missing the Bigger Picture: The Need for More Research on Visual Health Misinformation

Research shows that health misinformation is widespread online and poses a potentially significant threat to public health. Visual misinformation has been largely overlooked, a notable gap given the unique features and ubiquity of visual content. In this essay, we (a) provide a working definition of visual misinformation, (b) summarize the main categories of visual misinformation, (c) offer examples of the functions visuals can serve within misinformation content, and (d) outline priorities for advancing research on visual misinformation. A systematic approach to studying visual misinformation can improve efforts to mitigate health misinformation and optimize science communication in the current information environment.

Public Health Messaging during the COVID-19 Pandemic and Beyond: Lessons from Communication Science

The COVID-19 pandemic has made it clear that effective public health messaging is an indispensable component of a robust pandemic response system. In this article, we review decades of research from the interdisciplinary field of communication science and provide evidence-based recommendations for COVID-19 public health messaging. We take a principled approach by systematically examining the communication process, focusing on decisions about what to say in a message (i.e., message content) and how to say it (i.e., message executions), and how these decisions impact message persuasiveness. Following a synthesis of each major line of literature, we discuss how science-based principles of message design can be used in COVID-19 public health messaging. Additionally, we identify emerging challenges for public health messaging during the COVID-19 pandemic and discuss possible remedies. We conclude that communication science offers promising public health messaging strategies for combatting COVID-19 and future pandemics.

The effect of visual interventions on illness beliefs and medication adherence for chronic conditions: A scoping review of the literature and mapping to behaviour change techniques (BCTs)

BACKGROUND

Maintaining health with chronic conditions often involves taking multiple medications; however, approximately 50% of patients with chronic conditions are non-adherent to medication. Patients' illness beliefs inform health behaviour, including medication-taking. Research has shown that visuals accompanying health information increased patient comprehension and the accuracy of illness perceptions. To date, the influence of visuals on illness beliefs and medication adherence has not been comprehensively reviewed.

OBJECTIVES

The review aimed to collate available literature on visualisation interventions for illness beliefs and medication adherence in chronic conditions and identify key intervention characteristics.

METHODS

A scoping review was conducted according to recommended guidelines and the PRISMA-ScR statement. Searches used keywords relating to 'illness', 'visual', 'adherence', 'illness perception', 'intervention', and 'medication'. Six databases were searched from inception to 2019; reference-list searching provided additional articles. Articles were included if the study population had a chronic health condition, the intervention included a visual element, had a measure of illness beliefs or medication adherence. Data regarding intervention characteristics and outcomes were extracted. Behaviour change techniques (BCTs) were identified to provide further insight into intervention characteristics.

RESULTS

Initially, 18,012 articles were identified. Screening led to 293 full-text articles, ultimately resulting in 45 studies for final analysis. Forty-four were quantitative studies, 1 was qualitative. Studies were grouped into those using visuals to conceptualise a condition, medication reminders and educational interventions. Almost two-thirds of visual interventions were effective post-intervention, 3 sustained post-1-year, although many studies only assessed impact immediately post-intervention. BCTs from 'Natural consequences', 'Socialsupport' and 'Feedback and monitoring' categories were prevalent in effective interventions for both outcomes, particularly the 'Salience of consequences' BCT.

CONCLUSIONS

This comprehensive scoping review found that visual interventions can positively influence illness beliefs and medication adherence. These findings highlight the need to further evaluate the impact and sustainability of visual interventions.

The causes, impacts and countermeasures of COVID-19 "Infodemic": A systematic review using narrative synthesis

An unprecedented infodemic has been witnessed to create massive damage to human society. However, it was not thoroughly investigated. This systematic review aims to (1) synthesize the existing literature on the causes and impacts of COVID-19 infodemic; (2) summarize the proposed strategies to fight with COVID-19 infodemic; and (3) identify the directions for future research. A systematic literature search following the PRISMA guideline covering 12 scholarly databases was conducted to retrieve various types of peer-reviewed articles that reported causes, impacts, or countermeasures of the infodemic. Empirical studies were assessed for risk of bias using the Mixed-Methods Appraisal Tool. A coding theme was iteratively developed to categorize the causes, impacts, and countermeasures found from the included studies. Social media usage, low level of health/eHealth literacy, and fast publication process and preprint service are identified as the major causes of the infodemic. Besides, the vicious circle of human rumor-spreading behavior and the psychological issues from the public (e.g., anxiety, distress, fear) emerges as the characteristic of the infodemic. Comprehensive lists of countermeasures are summarized from different perspectives, among which risk communication and consumer health information need/seeking are of particular importance. Theoretical and practical implications are discussed and future research directions are suggested.