Practical recommendations to communicate with patients about health-related conspiracy theories

Conspiracy beliefs and intention to use conventional, complementary and alternative medicines: Two vignette studies

OBJECTIVE

Conspiracy beliefs (CBs) can have substantial consequences on health behaviours by influencing both conventional and non-conventional medicine uptake. They can target powerful groups (i.e. upward CBs) or powerless groups (i.e. downward CBs). Considering their repercussions in oncology, it appears useful to understand how CBs are related to the intentions to use conventional, complementary and alternative medicines (CAM).

DESIGN AND METHODS

This paper includes two pre-registered online correlational studies on a general French population (Study 1 N = 248, recruited on social media Mage = 40.07, SDage = 14.78; 205 women, 41 men and 2 non-binaries; Study 2 N = 313, recruited on social media and Prolific, Mage = 28.91, SDage = 9.60; 154 women, 149 men and 10 non-binaries). We investigated the links between generic and chemotherapy-related CBs and intentions to use conventional, complementary and alternative medicines. Study 2 consisted of a conceptual replication of Study 1, considering the orientation of CBs.

RESULTS

Generic CBs and chemotherapy-related CBs appear strongly and positively correlated, negatively correlated with intentions to take conventional medicine and positively with intentions to take CAM. The link between generic CBs and medication intention is fully mediated by chemotherapy-related CBs. When distinguished, upward CBs are a stronger predictor of chemotherapy-related CBs than downward CBs.

CONCLUSIONS

The findings suggest that intentions to use medicine are strongly associated with CBs. This has several important implications for further research and practice, notably on the presence and effects of CBs on medication behaviours in cancer patients.

Investigating Beliefs in Anti-Vax Conspiracy Theories among Medical Students

While the doctors' role in immunization is essential, their lack of knowledge or vaccine hesitancy may affect their ability to communicate effectively and educate patients about vaccination, vaccine hesitancy, and vaccine conspiracy theories. This, in turn, may hinder health policy aimed at fighting infectious diseases. Vaccine hesitancy is prevalent not only among the general population but also among healthcare workers; thus, this study is aimed at assessing future doctors' attitudes towards anti-vax conspiracy theories. A total of 441 medical students at Poznan University of Medical Sciences completed a web-based survey designed to explore their attitudes toward the six most prevalent anti-vaccine conspiracy theories. The survey showed that although over 97% of future doctors support vaccinations as an effective form of fighting infectious diseases, and 80% did not believe in any anti-vax conspiracy theory, a significant fraction of 20% of medical students either believed in at least one such theory or were unsure. It has also shown that male and younger students who had not received a flu vaccination and defined themselves as politically right-wing or conservative and religious were more likely to believe in anti-vax conspiracy theories. Our data suggest that, in order to overcome medical students' ambivalent attitudes towards anti-vax conspiracy theories, they should receive more education about the importance of vaccination in preventing disease and about effective ways to combat vaccine hesitancy and anti-vax conspiracy theories.

Effects of Beliefs, Conspiracy Theories, and Vaccine Hesitancy on the Vaccination Status of Patients with Severe Mental Illness in a Tertiary Psychiatric Care Hospital in Türkiye

Background

The aim of the study was to investigate the relationship between the vaccination rates and vaccine hesitancy and the adoption of conspiracy theories by patients with severe mental illness in Türkiye.

Methods

Ninety-eight outpatients with schizophrenia and 105 outpatients with bipolar disorder were included. A sociodemographical data form, a survey on beliefs and conspiracy theories on vaccines and Vaccine Hesitancy Scale were obtained. Vaccinated and unvaccinated groups were compared and evaluated separately for patients with schizophrenia and bipolar disorder.

Results

Sixty-one (62.24%) patients in the schizophrenia group and 86 (81.90%) patients in the bipolar disorder group were vaccinated, and the vaccination rate in the schizophrenia group was significantly lower (P = .002). There was no significant difference in terms of Vaccine Hesitancy Scale scores or adoption of any particular conspiracy theory between patients with schizophrenia and bipolar groups. However, vaccinated and unvaccinated patients of schizophrenia and bipolar disorder groups differed in terms of adopting beliefs and conspiracy theories on vaccines. Sixty-five (75.58%) of the vaccinated patients in the bipolar group agreed with the statement "vaccines are safe," while this rate was 8 (42.11%) in the unvaccinated patients (P = .004). In the schizophrenia group, however, the main difference between the vaccinated and unvaccinated patients was adopting the beliefs that "vaccines have serious side effects" and "vaccines may cause homosexuality" (P = .0341 and P = .003, respectively).

Conclusion

The vaccination status of patients with schizophrenia might be under the stronger influence of conspiracy theories and specialized mental health interventions may be needed to ensure vaccination in patients with schizophrenia.

Validating a German Version of the Conspiracy Mentality Scale (CMS)

Increased scientific interest in conspiracy beliefs raises the need for validated individual difference measures in the general tendency to believe in conspiracy theories, otherwise referred to as conspiracy mentality. In this article, we present a German language version of the Conspiracy Mentality Scale (CMS). A representative sample of German-speaking Swiss residents (N = 468) filled in the scale, along with measures of trust in several sources of information, need for social validation, compliance with Covid-19 preventive measures, perceived severity of the pandemic, loneliness, functional literacy and interpersonal conflict. Confirmatory factor analysis supported the two-dimensional structure of the original scale. Positive correlations between conspiracy theory ideation and trust in friends and the need for social validation on the one hand, and negative correlations with trust in scientific publications and scientific experts, perceived severity of the pandemic and functional literacy on the other hand supported construct validity. We conclude that our German language version of the scale is a valid measure of conspiracy theory ideation and skepticism.

A conceptual model on caregivers' hesitancy of topical fluoride for their children

BACKGROUND

Topical fluoride hesitancy is a well-documented and growing public health problem. Despite extensive evidence that topical fluoride is safe and prevents tooth decay, an increasing number of caregivers are hesitant about their children receiving topical fluoride, leading to challenges in clinical settings where caregivers refuse preventive care.

PURPOSE

To explore the determinants of topical fluoride hesitancy for caregivers with dependent children.

METHODS

In this qualitative study, we interviewed 56 fluoride-hesitant caregivers to develop an inductive conceptual model of reasons why caregivers are hesitant.

RESULTS

The core construct of the conceptual model of topical fluoride hesitancy centered on caregivers "wanting to protect and not mess up their child". Six domains comprised this core construct: thinking topical fluoride is unnecessary, wanting to keep chemicals out of my child's body, thinking fluoride is harmful, thinking there is too much uncertainty about fluoride, feeling pressured to get topical fluoride, and feeling fluoride should be a choice.

CONCLUSIONS

Topical fluoride hesitancy is complex and multifactorial. Study findings provide insight for future efforts to understand and optimize caregivers' preventive care decision making.

Public policy and conspiracies: The case of mandates

Although conspiracy theories are only endorsed by a minority, conspiracy theories can nonetheless compromise public health measures to control the COVID-19 pandemic. Individuals who endorse conspiracy theories were less likely to wear masks, comply with social distancing, or get vaccinated. This poses a challenge to public health policy, in particular because vaccine uptake lags behind targets because of resistance from a relatively small, but highly vocal, number of people. One policy tool is to enact vaccine mandates, which, while controversial, have successfully increased vaccination uptake. In this article, we review the evidence about whether mandates can be successful, and whether they trigger increased opposition and conspiracy beliefs. We discuss the implications for using mandates in public health policy and argue that decisions about mandates need to be weighed against the consequences of alternative measures—which may also increase conspiracy beliefs albeit for different reasons.