Effects of Prior Exposure to Conflicting Health Information on Responses to Subsequent Unrelated Health Messages: Results from a Population-Based Longitudinal Experiment

Deciphering Discord: How Conflicting Information and Political Ideology Shape Public Attitude Toward PFAS Regulation

Per- and polyfluorinated substances (PFAS) contamination is an emerging environmental and health risk facing the world. This study examines the impact of conflicting information on Americans' attitude toward PFAS regulation and intention to engage in mitigation behaviors through a one-way, between-subjects experiment. Participants were 1,062 U.S. adults recruited from CloudResearch. Results showed that compared to participants exposed to consistent information, those exposed to conflicting information displayed less favorable attitude toward existing regulation, which led to lower intention to support related policies and to engage in mitigation behaviors. Political ideology moderated these relationships, with stronger experimental effects among conservatives. These findings underscore the importance of conveying consistent risk messages, especially when multiple stakeholders are involved.

Effects of Exposure to Conflicting Health Information on Topic-Specific Information Sharing and Seeking Intentions

Despite considerable evidence that exposure to conflicting health information can have undesirable effects on outcomes including public understanding about and trust in health recommendations, comparatively little is known about whether such exposure influences intentions to engage in two communication behaviors central to public health promotion: information sharing and information seeking. The purpose of the current study is to test whether exposure to conflicting information influences intentions to share and seek information about six health topics. We analyzed data from two waves of a longitudinal survey experiment with a nationally representative sample of U.S. adults (N = 3,920). Participants were randomly assigned to either a conflict or no-conflict message condition, in which they read news stories and social media posts about three (of six) randomly selected health topics at Time 1 and the remaining three at Time 2. The dependent variables, which were measured at Time 2, asked participants whether they intended to share or seek information about the three topics they had just viewed. Linear mixed effects models showed that exposure to conflict reduced intentions to share and seek information, regardless of health topic. These findings suggest that exposure to conflicting health information discourages two important types of health information engagement, thus adding to the growing evidence base documenting the adverse consequences of conflicting information for public health.

Effects of Scanning Health News Headlines on Trust in Science: An Emotional Framing Perspective

Rooted in the emotions-as-frames model (EFM), this research examines how hope, fear, and annoyance are evoked through health news headline scanning, and how these emotions influence perceptions of news and medical science institutions as well as health behavioral intentions. A sample of U.S. adults (N = 327) were assigned to one of four headline framing conditions expected to associate with different emotions (positive future frame-hope; threat frame-fear/anxiety; reversal frame-annoyance; and control-neutral) and then asked about their emotional states, trust in science and news, and health-related behavioral intentions. Overall, health news headlines generated more hope than any other emotion across all conditions, and positive future-framed headlines evoked more hope than other framed headlines. Felt hope, in turn, generated greater trust in news and science, higher expectations of medical breakthroughs and cures, and greater intention to engage in preventative health behaviors. Felt anxiety had marginal positive benefits whereas felt annoyance negatively impacted the outcomes of interest. Notably, felt emotion mediated the headline frame-outcome relationships in the positive future/hope condition. These findings offer some support for the EFM and demonstrate that scanning headlines imbued with specific emotional frames can influence important health-related outcomes through the emotions they evoke. We discuss both the theoretical and practical implication of these findings.

Hot Topic: A Systematic Review and Content Analysis of Heat-Related Messages During the 2021 Heat Dome in Canada

CONTEXT

During the summer of 2021, western Canada experienced a deadly heat event. From the first heat alert to postevent reporting, thousands of media articles were published that reference the heat event. However, a gap remains in understanding how this communication chain-from the release of a public heat alert to information shared through media outlets to the public-currently operates to disseminate heat-related messaging across Canada.

OBJECTIVE

To understand the role of digital media in delivering heat-health messaging during an extreme heat event in Canada.

DESIGN

A qualitative content analysis was conducted using Canadian news articles published on the 2021 Heat Dome between June 2021 and February 2022 (n = 2909). The coding frame was designed to align with the basic framework for information gathering used in journalism (who, what, where, when, and how) and included both concept-driven and data-driven codes.

RESULTS

Overall, 2909 unique media articles discussing the 2021 Heat Dome were identified, with the majority (74%) published by online news agencies (how). The highest article count was on June 29, 2021 (n = 159), representing 5% of the total data set (n = 2909) spanning 260 days (when); 57% of the identified locations were in British Columbia (where). Although we found that the top voices providing media-based heat-health messages are government officials (who), only 23% of articles included heat-health messaging that aligns with the government health alert bulletins released during extreme heat. In addition, heat-health messaging frequently included contradictory content, inconsistent language, or incorrect advice (what).

CONCLUSION

The findings demonstrate clear opportunities to improve health communication related to extreme heat, perhaps most importantly, including updates to mass media messaging educating the public on heat-protective behaviors.

Sustaining positive perceptions of science in the face of conflicting health information: An experimental test of messages about the process of scientific discovery

BACKGROUND

The public is often exposed to conflicting health information, with evidence of concerning consequences, yet little attention has been paid to identifying strategies that can mitigate its effects.

OBJECTIVE

The current study tests whether three different approaches to communicating about the process of scientific discovery-a rational appeal using analogical evidence, a rational appeal using testimonial evidence, and a logic-based inoculation approach-could reduce the adverse effects of exposure to conflict by positively framing how people construe the scientific process, increasing their perceived knowledge about the scientific process, and helping them to respond to critiques about the scientific process, which, in turn, might make them less apt to counterargue the science they subsequently encounter in health news stories and other exposures to conflict.

METHODS

We fielded a survey experiment in May 2022 with a national sample of U.S. adults (N = 1604).

RESULTS

Providing any of the three messages about science prior to exposure to conflicting health information encouraged both positive construal of science and greater science knowledge perceptions and discouraged counterarguing science, compared to a control condition in which people were only exposed to conflict. Of the three messaging approaches tested, the testimonial evidence message was slightly more effective, but was also considered slightly more accurate, credible, and trustworthy.

CONCLUSIONS

Developing and implementing messages that describe the process of scientific discovery could prove successful, not only in improving public perceptions of science but perhaps ultimately in better equipping people to make sense of conflicting information and its causes. However, additional research on such strategies is needed, particularly as part of larger interventions with multiple messages across multiple exposures, if they are to have implications for health and science communication.

Effects of Exposure to Conflicting Information About Mammography on Cancer Information Overload, Perceived Scientists' Credibility, and Perceived Journalists' Credibility

Conflicting recommendations about mammography screening have received ample media coverage, emphasizing scientists' debate over the value of breast cancer screening and differences in professional organizations' guidelines about the appropriate starting age and frequency of routine mammograms. Whereas past research suggests that exposure to such media coverage of conflicting recommendations can have undesirable consequences, both on topic-specific (e.g., ambivalence about mammography) and more general outcomes (e.g., backlash toward cancer prevention recommendations), experimental evidence, especially for effects on more general health cognitions, is limited. Using data from a population-based sample of U.S. women aged 35-55 years (N = 1467), the current study experimentally tested whether exposure to news stories that varied in the level of conflict about mammography (no, low, medium, and high conflict) affected three general health cognitions-cancer information overload (CIO), perceived scientists' credibility, and perceived journalists' credibility. We further tested whether these effects varied by research literacy. Results showed that exposure to conflict increased women's perceived CIO and reduced their perceptions of journalists' credibility, and that these effects tapered off at higher levels of conflict. Exposure to conflict also reduced perceptions of scientists' credibility, but only among participants with lower levels of research literacy. Directions for future research and implications for mitigating these potentially adverse effects on public health are discussed.

Vulnerability to the Effects of Conflicting Health Information: Testing the Moderating Roles of Trust in News Media and Research Literacy

BACKGROUND

Exposure to conflicting health information can produce negative affective and cognitive responses, including confusion and backlash, and the effects of this exposure can even "carry over" and reduce people's receptivity to subsequent messages about health behaviors for which there is scientific consensus. What is not known is whether certain population subgroups are more vulnerable to such carryover effects.

AIMS

This study investigates whether carryover effects of exposure to conflicting information are moderated by two factors, trust in news media and research literacy, testing the hypothesis that lower trust and higher literacy could protect against such effects.

METHOD

The analysis draws on data from a longitudinal population-based experiment (N = 2,716), in which participants were randomly assigned to view health news stories and social media posts that either did or did not feature conflicting information, and subsequently exposed to ads from existing health campaigns about behaviors for which there is scientific consensus. Structural equation modeling was used to test study hypotheses.

RESULTS

Neither lower trust in news media nor higher research literacy protected against carryover effects, as effects were observed across levels of both trust and literacy. Although level of research literacy did not affect whether carryover effects were observed, it did shape how those effects emerged.

CONCLUSION

The public, regardless of their level of trust in news media or research literacy, is vulnerable to the downstream effects of exposure to conflicting health information. Targeted health communication interventions are needed to improve messaging about evolving science and, in turn, increase receptivity to public health recommendations.

Relationship of Exposure to Contradictory Information and Information Insufficiency to Decision-Making About HPV Vaccination Among South Korean College Women

In this study, we investigated how exposure to contradictory messages about the human papillomavirus (HPV) vaccine affects female South Korean college students' vaccination decisions. Specifically, we focused on the relationship between exposure to contradictory messages, current knowledge, and information insufficiency that may affect participants' confusion and decision-making about vaccination. A percentile bootstrap method and pairwise comparison tests in structural equation modeling were employed. Exposure to contradictory messages significantly and negatively affected current knowledge of the HPV vaccine. Although current knowledge significantly and negatively affected confusion around the vaccine, information insufficiency failed to predict it. The vaccine confusion significantly and positively affected decisional conflicts, which, in turn, decreased the behavioral intentions to vaccinate. Additionally, the results showed how the participants' altruistic orientations and perceived stigma moderated the associations among the variables. The findings have theoretical and practical implications for future research investigating the effects of vaccine-related information on young adult women's decision-making about vaccination, particularly in cultural contexts where the HPV vaccine uptake rates are low.

Why do experts disagree? The development of a taxonomy

People are increasingly exposed to conflicting health information and must navigate this information to make numerous decisions, such as which foods to consume, a process many find difficult. Although some consumers attribute these disagreements to aspects related to uncertainty and complexity of research, many use a narrower set of credibility-based explanations. Experts' views on disagreements are underinvestigated and lack explicit identification and classification of the differences in causes for disagreement. Consequently, there is a gap in existing literature to understand the range of reasons for these contradictions. Combining the findings from a literature study and expert interviews, a taxonomy of disagreements was developed. It identifies 10 types of disagreement classified under three dimensions: informant-, information- and uncertainty-related causes for disagreement. The taxonomy may assist with adoption of more effective strategies to deal with conflicting information and contributes to research and practice of science communication in the context of disagreement.

Understanding responses to different types of conflicting information about cancer prevention

BACKGROUND

Individuals are regularly exposed to conflicting information about health; however, understanding of how individuals respond to different types of conflicting information is limited.

METHODS

In total, 1027 US adults were randomly assigned to 1 of 8 conflicting information messages about nutrition and cancer risk, depicting 1/4 conflicting information types (conflict in evidence - sources A and B agree the evidence is mixed; conflict between two expert sources - sources A and B present conflicting evidence about nutrition and cancer risk; conflict within the same expert source - source A changes its own recommendation about the evidence; no conflict control) crossed by 1/2 baseline recommendations with which new information conflicted (limit vs. do not limit red meat intake to reduce cancer risk).

RESULTS

Compared to the control, each conflicting information type led to lower perceived scientific consensus about how much red meat one should eat (p < .001); conflict in evidence (p = .004) and between sources (p = .006) led to lower trust in scientists. Intentions to consume red meat more frequently were higher in the conflicting information conditions than control in the group initially told to "limit red meat" and lower in the "do not limit red meat" group (p = .022). Conflict within the same source led to higher perceived scientific consensus compared to conflict in evidence (p = .007) and between sources (p = .013); it also lowered intentions to consume red meat more frequently compared to conflict in evidence, but only in the "do not limit red meat" condition (p = .033). Conflict in evidence (p = .007) and within the same source (p = .013) increased cancer fatalism compared to conflict between sources.

CONCLUSIONS

Conflict in scientific evidence and conflict arising from the same expert source (e.g., a changing public health guideline) may have pernicious effects. Future efforts could investigate how best to publicly communicate these instances of scientific conflict to minimize negative impact.

Americans' perceptions of health disparities over the first year of the COVID-19 pandemic: Results from three nationally-representative surveys

COVID-19 has illuminated health inequity in the United States. The burdens of disease are much higher among Black and Indigenous people and other people of color. Disparities by income are also profound, as lower-wage workers were less able to adopt mitigating behaviors compared to higher-income counterparts. These disparities became part of public health discourse in 2020, with commentators frequently highlighting the connection between racism, socioeconomic position, and COVID-19. But what proportion of the public-and among key subgroups-recognized these social group disparities, relative to disparities associated with age and chronic illness, and did public recognition change over the first year of the pandemic? To address these questions, we analyzed data from three nationally-representative cross-sectional public opinion surveys, collected using the NORC AmeriSpeak panel in April 2020 (N = 1007), August 2020 (N = 2716), and April 2021 (N = 1020). The key outcomes were respondents' agreement with statements about disparities in COVID-19 mortality by age, chronic illness, income, and race. We found little change from 2020 to 2021 in Americans' recognition of disparities. At all three time points, most respondents acknowledged age and chronic illness disparities, while no more than half at any time point recognized income- and race-based disparities. Political party affiliation was not statistically associated with agreement with age or illness-related disparities, but was strongly associated with views about income- and race-based disparities. Efforts to promote recognition of racial and socioeconomic health disparities in the United States need to be mindful of the ways in which public understanding of health inequities is linked to partisanship.

Effects of politicized media coverage: Experimental evidence from the HPV vaccine and COVID-19

Although concerns about politicization of health and science are not new, the COVID-19 pandemic has amplified attention to how political disagreement over scientific guidelines and recommendations might influence attitudes and behaviors about the health topics in question and might even spill or carry over to affect other attitudes important to public health. The literature employs differing definitions of politicization—at times referring to controversy in the public sphere, at others referring to the exploitation of the uncertainty inherent in science, and at still others referring to whether the issue enters political discourse—all of which are viewed as distinct dimensions by the public. What is not known is how these different aspects of politicization influence public attitudes about the health topics and or broader attitudes about scientific guidelines, and—assuming adverse effects—what strategies might be effective at mitigating the consequences. This paper draws on a survey experiment of 3012 U.S. respondents fielded in summer 2020 that was designed as a pilot study to assess the effects of different dimensions of politicization. Findings do not suggest that one type of politicization is necessarily more pernicious than the others. In fact, all types of politicization increased negative emotional responses and confusion, both with respect to the health topic in question (HPV vaccine and COVID-19) but also on other domains, although opinions about policy were unaffected. The findings also suggest that inoculation may have potential as a messaging strategy for blunting the adverse effects of exposure to politicization.

Debunking Health Misinformation on Social Media: The Challenge of Dynamic Conversations (Preprint)

Background

The spread of false and misleading health information on social media can cause individual and social harm. Research on debunking has shown that properly designed corrections can mitigate the impact of misinformation, but little is known about the impact of correction in the context of prolonged social media debates. For example, when a social media user takes to Facebook to make a false claim about a health-related practice and a health expert subsequently refutes the claim, the conversation rarely ends there. Often, the social media user proceeds by rebuking the critic and doubling down on the claim.

Objective

The aim of this study was to examine the impact of such extended back and forth between false claims and debunking attempts on observers’ dispositions toward behavior that science favors. We tested competing predictions about the effect of extended exposure on people’s attitudes and intentions toward masking in public during the early days of the COVID-19 pandemic and explored several psychological processes potentially underlying this effect.

Methods

A total of 500 US residents took part in an online experiment in October 2020. They reported on their attitudes and intentions toward wearing masks in public. They were then randomly assigned to one of four social media exposure conditions (misinformation only vs misinformation+correction vs misinformation+correction+rebuke vs misinformation+correction+rebuke+second correction), and reported their attitudes and intentions for a second time. They also indicated whether they would consider sharing the thread if they were to see it on social media and answered questions on potential mediators and covariates.

Results

Exposure to misinformation had a negative impact on attitudes and intentions toward masking (β=–.35, 95% CI –.42 to –.29; P<.001). Moreover, initial debunking of a false claim generally improved attitudes and intentions toward masking (β=.35, 95% CI .16 to .54; P<.001). However, this improvement was washed out by further exposure to false claims and debunking attempts (β=–.53, 95% CI –.72 to –.34; P<.001). The latter result is partially explained by a decrease in the perceived objectivity of truth. That is, extended exposure to false claims and debunking attempts appear to weaken the belief that there is an objectively correct answer to how people ought to behave in this situation, which in turn leads to less positive reactions toward masking as the prescribed behavior.

Conclusions

Health professionals and science advocates face an underappreciated challenge in attempting to debunk misinformation on social media. Although engaging in extended debates with science deniers and other purveyors of bunk appears necessary, more research is needed to address the unintended consequences of such engagement.