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      Effects of an Online Community Peer-support Intervention on COVID-19 Vaccine Misinformation Among Essential Workers: Mixed-methods Analysis

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          Abstract

          Introduction

          Public health efforts to reduce the spread of coronavirus disease 2019 (COVID-19) have been plagued by vaccine hesitancy and misinformation. Social media has contributed to spreading misinformation by creating online environments where people find information or opinions that reinforce their own. Combating misinformation online will be essential to prevent and manage the spread of COVID-19. It is of particular urgency to understand and address misinformation and vaccine hesitancy among essential workers, such as healthcare workers, because of their frequent interactions with and influence upon the general population. Using data from an online community pilot randomized controlled trial designed to increase requests for COVID-19 vaccine information among frontline essential workers, we explored the topics discussed on the online community related to COVID-19 and COVID-19 vaccination to better understand current misinformation and vaccine hesitancy.

          Methods

          For the trial, 120 participants and 12 peer leaders were recruited through online advertisements to join a private, hidden Facebook group. The study consisted of an intervention and control arm, each with two groups of 30 randomized participants each. Peer leaders were only randomized into one of the intervention-arm groups. Peer leaders were tasked with engaging the participants throughout the study. Posts and comments of only participants were coded manually by the research team. Chi-squared tests assessed differences in the frequency and content of posts between intervention and control arms.

          Results

          We found significant differences in the numbers of posts and comments focused on topics of general community, misinformation, and social support between intervention and control arms (6.88% vs 19.05% focused on misinformation, respectively, (P <0.001); 11.88% vs 1.90% focused on social support, respectively, (P <0.001); and 46.88% vs 62.86% focused on general community (P <0.001)).

          Conclusion

          Results suggest that peer-led online community groups may help to reduce the spread of misinformation and aid public health efforts in our fight against COVID-19.

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          Most cited references15

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          The spreading of misinformation online.

          The wide availability of user-provided content in online social media facilitates the aggregation of people around common interests, worldviews, and narratives. However, the World Wide Web (WWW) also allows for the rapid dissemination of unsubstantiated rumors and conspiracy theories that often elicit rapid, large, but naive social responses such as the recent case of Jade Helm 15--where a simple military exercise turned out to be perceived as the beginning of a new civil war in the United States. In this work, we address the determinants governing misinformation spreading through a thorough quantitative analysis. In particular, we focus on how Facebook users consume information related to two distinct narratives: scientific and conspiracy news. We find that, although consumers of scientific and conspiracy stories present similar consumption patterns with respect to content, cascade dynamics differ. Selective exposure to content is the primary driver of content diffusion and generates the formation of homogeneous clusters, i.e., "echo chambers." Indeed, homogeneity appears to be the primary driver for the diffusion of contents and each echo chamber has its own cascade dynamics. Finally, we introduce a data-driven percolation model mimicking rumor spreading and we show that homogeneity and polarization are the main determinants for predicting cascades' size.
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            Coronavirus Goes Viral: Quantifying the COVID-19 Misinformation Epidemic on Twitter

            Background Since the beginning of the coronavirus disease 2019 (COVID-19) epidemic, misinformation has been spreading uninhibited over traditional and social media at a rapid pace. We sought to analyze the magnitude of misinformation that is being spread on Twitter (Twitter, Inc., San Francisco, CA) regarding the coronavirus epidemic.  Materials and methods We conducted a search on Twitter using 14 different trending hashtags and keywords related to the COVID-19 epidemic. We then summarized and assessed individual tweets for misinformation in comparison to verified and peer-reviewed resources. Descriptive statistics were used to compare terms and hashtags, and to identify individual tweets and account characteristics. Results The study included 673 tweets. Most tweets were posted by informal individuals/groups (66%), and 129 (19.2%) belonged to verified Twitter accounts. The majority of included tweets contained serious content (91.2%); 548 tweets (81.4%) included genuine information pertaining to the COVID-19 epidemic. Around 70% of the tweets tackled medical/public health information, while the others were pertaining to sociopolitical and financial factors. In total, 153 tweets (24.8%) included misinformation, and 107 (17.4%) included unverifiable information regarding the COVID-19 epidemic. The rate of misinformation was higher among informal individual/group accounts (33.8%, p: <0.001). Tweets from unverified Twitter accounts contained more misinformation (31.0% vs 12.6% for verified accounts, p: <0.001). Tweets from healthcare/public health accounts had the lowest rate of unverifiable information (12.3%, p: 0.04). The number of likes and retweets per tweet was not associated with a difference in either false or unverifiable content. The keyword “COVID-19” had the lowest rate of misinformation and unverifiable information, while the keywords “#2019_ncov” and “Corona” were associated with the highest amount of misinformation and unverifiable content respectively. Conclusions Medical misinformation and unverifiable content pertaining to the global COVID-19 epidemic are being propagated at an alarming rate on social media. We provide an early quantification of the magnitude of misinformation spread and highlight the importance of early interventions in order to curb this phenomenon that endangers public safety at a time when awareness and appropriate preventive actions are paramount.
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              Public Health and Online Misinformation: Challenges and Recommendations

              The internet has become a popular resource to learn about health and to investigate one's own health condition. However, given the large amount of inaccurate information online, people can easily become misinformed. Individuals have always obtained information from outside the formal health care system, so how has the internet changed people's engagement with health information? This review explores how individuals interact with health misinformation online, whether it be through search, user-generated content, or mobile apps. We discuss whether personal access to information is helping or hindering health outcomes and how the perceived trustworthiness of the institutions communicating health has changed over time. To conclude, we propose several constructive strategies for improving the online information ecosystem. Misinformation concerning health has particularly severe consequences with regard to people's quality of life and even their risk of mortality; therefore, understanding it within today's modern context is an extremely important task.
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                Author and article information

                Journal
                West J Emerg Med
                West J Emerg Med
                WestJEM
                Western Journal of Emergency Medicine
                Department of Emergency Medicine, University of California, Irvine School of Medicine
                1936-900X
                1936-9018
                March 2023
                27 February 2023
                : 24
                : 2
                : 264-268
                Affiliations
                University of California, Irvine, Department of Emergency Medicine, Orange, California
                Author notes
                Address for Correspondence: Dominic Arjuna Ugarte, MD, Staff Research Associate III, University of California, Irvine, Department of Emergency Medicine, 3800 W. Chapman Ave, Suite 3200, Orange, CA 92868, dugarte@ 123456hs.uci.edu
                Article
                wjem-24-264
                10.5811/westjem.2023.1.57253
                10047750
                36976597
                7f7576a9-c478-4c1b-9ea2-60aaf3344996
                © 2023 Ugarte et al.

                This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/

                History
                : 27 April 2023
                : 23 January 2023
                : 09 January 2023
                Categories
                Endemic Infection
                Original Research

                Emergency medicine & Trauma
                Emergency medicine & Trauma

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