Early COVID-19 Home-Based Care Knowledge and Efficacies: Comparing Ghanaian and US Respondents.

Home-based care messages were part of behavioral modification interventions to mitigate COVID-19 spread early in the pandemic. What remains unclear is the types of home-based care knowledge people have and whether different kinds of home-based care knowledge influence a person's self-efficacy and response efficacy in managing mild cases. Using a cross-sectional online survey, this exploratory study investigated differences in biomedical and alternative knowledge about COVID-19 home-based care and their association with self and response efficacy from respondents in Ghana and the US. With a total sample of 736 made up of 50.3% from Ghana and 49.7% from the US, the average age range was of 39-48 years. Sixty two percent were females and 38% males. Using chi-square goodness of fit tests, t-tests, and multiple regression for analysis, we found that US respondents had higher biomedical knowledge while Ghanaian respondents had higher alternative knowledge. Although self-efficacy and response efficacy were high in both countries, both kinds of knowledge did not independently improve respondents' self-efficacy or response efficacy. However, a combination of biomedical and alternative home-based care knowledge items predicted self and response efficacy. Health promoters need to consider ways of utilizing both knowledge types in a complimentary manner during disease outbreaks.

Using Normative Language When Describing Scientific Findings: Randomized Controlled Trial of Effects on Trust and Credibility.

BACKGROUND: Scientists often make cognitive claims (eg, the results of their work) and normative claims (eg, what should be done based on those results). Yet, these types of statements contain very different information and implications. This randomized controlled trial sought to characterize the granular effects of using normative language in science communication. OBJECTIVE: Our study examined whether viewing a social media post containing scientific claims about face masks for COVID-19 using both normative and cognitive language (intervention arm) would reduce perceptions of trust and credibility in science and scientists compared with an identical post using only cognitive language (control arm). We also examined whether effects were mediated by political orientation. METHODS: This was a 2-arm, parallel group, randomized controlled trial. We aimed to recruit 1500 US adults (age 18+) from the Prolific platform who were representative of the US population census by cross sections of age, race/ethnicity, and gender. Participants were randomly assigned to view 1 of 2 images of a social media post about face masks to prevent COVID-19. The control image described the results of a real study (cognitive language), and the intervention image was identical, but also included recommendations from the same study about what people should do based on the results (normative language). Primary outcomes were trust in science and scientists (21-item scale) and 4 individual items related to trust and credibility; 9 additional covariates (eg, sociodemographics, political orientation) were measured and included in analyses. RESULTS: From September 4, 2022, to September 6, 2022, 1526 individuals completed the study. For the sample as a whole (eg, without interaction terms), there was no evidence that a single exposure to normative language affected perceptions of trust or credibility in science or scientists. When including the interaction term (study arm × political orientation), there was some evidence of differential effects, such that individuals with liberal political orientation were more likely to trust scientific information from the social media post's author if the post included normative language, and political conservatives were more likely to trust scientific information from the post's author if the post included only cognitive language (ß=0.05, 95% CI 0.00 to 0.10; P=.04). CONCLUSIONS: This study does not support the authors' original hypotheses that single exposures to normative language can reduce perceptions of trust or credibility in science or scientists for all people. However, the secondary preregistered analyses indicate the possibility that political orientation may differentially mediate the effect of normative and cognitive language from scientists on people's perceptions. We do not submit this paper as definitive evidence thereof but do believe that there is sufficient evidence to support additional research into this topic, which may have implications for effective scientific communication. TRIAL REGISTRATION: OSF Registries osf.io/kb3yh; https://osf.io/kb3yh. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/41747.

Using Normative Language When Describing Scientific Findings: Protocol for a Randomized Controlled Trial of Effects on Trust and Credibility.

BACKGROUND: Trust in science and scientists has received renewed attention because of the "infodemic" occurring alongside COVID-19. A robust evidence basis shows that such trust is associated with belief in misinformation and willingness to engage in public and personal health behaviors. At the same time, trust and the associated construct of credibility are complex meta-cognitive concepts that often are oversimplified in quantitative research. The discussion of research often includes both normative language (what one ought to do based on a study's findings) and cognitive language (what a study found), but these types of claims are very different, since normative claims make assumptions about people's interests. Thus, this paper presents a protocol for a large randomized controlled trial to experimentally test whether some of the variability in trust in science and scientists and perceived message credibility is attributable to the use of normative language when sharing study findings in contrast to the use of cognitive language alone. OBJECTIVE: The objective of this trial will be to examine if reading normative and cognitive claims about a scientific study, compared to cognitive claims alone, results in lower trust in science and scientists as well as lower perceived credibility of the scientist who conducted the study, perceived credibility of the research, trust in the scientific information on the post, and trust in scientific information coming from the author of the post. METHODS: We will conduct a randomized controlled trial consisting of 2 parallel groups and a 1:1 allocation ratio. A sample of 1500 adults aged ≥18 years who represent the overall US population distribution by gender, race/ethnicity, and age will randomly be assigned to either an "intervention" arm (normative and cognitive claims) or a control arm (cognitive claims alone). In each arm, participants will view and verify their understanding of an ecologically valid claim or set of claims (ie, from a highly cited, published research study) designed to look like a social media post. Outcomes will be trust in science and scientists, the perceived credibility of the scientist who conducted the study, the perceived credibility of the research, trust in the scientific information on the post, and trust in scientific information coming from the author of the post. Analyses will incorporate 9 covariates. RESULTS: This study will be conducted without using any external funding mechanisms. CONCLUSIONS: If there is a measurable effect attributable to the inclusion of normative language when writing about scientific findings, it should generate discussion about how such findings are presented and disseminated. TRIAL REGISTRATION: Open Science Framework n7yfc; https://osf.io/n7yfc. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/41747.

Comparing how information source and trust influence risk perception about Ebola in Ghana and Liberia.

The increasing occurrence of diseases across geographical borders creates a need to understand how information source preferences and trust in those sources influence risk perception across contexts. However, cross-context studies about information sources are not common in health communication and promotion scholarship. Using a survey, the research team compared how information sources, perceived usefulness of Ebola information, interpersonal and social trust and context influence risk perception and self-efficacy in an Ebola-affected (Liberia) and -unaffected (Ghana) country. Respondents from the unaffected country trusted the information they received significantly more and had higher levels of interpersonal and social trust than respondents from the affected country. These findings reinforce the use of community health workers as channels to support behavior and social change-focused programs, particularly in crisis situations, in addition to other information channels and sources.

In places such as West Africa, where porous borders allow for easy flow of commodities and pathogens, increases in new and emerging infectious diseases, call for understanding how information sources and trust in these source influence risk perception and self-efficacy about disease. Using a survey, the research team compared differences in sources of information, trust in information sources and how these influenced respondents' risk perception and self-efficacy regarding the 2013­2016 Ebola outbreak among respondents in Ghana and Liberia. The study found that interpersonal sources (both traditional and mediated) were preferred and trusted in both countries. Respondents in both countries would prefer to receive information about home treatment options in future disease outbreaks. Health promotion campaigns need to consider nuance in the type and use of interpersonal sources.

Intervening on Trust in Science to Reduce Belief in COVID-19 Misinformation and Increase COVID-19 Preventive Behavioral Intentions: Randomized Controlled Trial.

BACKGROUND: Trust in science meaningfully contributes to our understanding of people's belief in misinformation and their intentions to take actions to prevent COVID-19. However, no experimental research has sought to intervene on this variable to develop a scalable response to the COVID-19 infodemic. OBJECTIVE: Our study examined whether brief exposure to an infographic about the scientific process might increase trust in science and thereby affect belief in misinformation and intention to take preventive actions for COVID-19. METHODS: This two-arm, parallel-group, randomized controlled trial aimed to recruit a US representative sample of 1000 adults by age, race/ethnicity, and gender using the Prolific platform. Participants were randomly assigned to view either an intervention infographic about the scientific process or a control infographic. The intervention infographic was designed through a separate pilot study. Primary outcomes were trust in science, COVID-19 narrative belief profile, and COVID-19 preventive behavioral intentions. We also collected 12 covariates and incorporated them into all analyses. All outcomes were collected using web-based assessment. RESULTS: From January 22, 2021 to January 24, 2021, 1017 participants completed the study. The intervention slightly improved trust in science (difference-in-difference 0.03, SE 0.01, t1000=2.16, P=.031). No direct intervention effect was observed on belief profile membership, but there was some evidence of an indirect intervention effect mediated by trust in science (adjusted odds ratio 1.06, SE 0.03, 95% CI 1.00-1.12, z=2.01, P=.045) on membership in the "scientific" profile compared with the others. No direct nor indirect effects on preventive behaviors were observed. CONCLUSIONS: Briefly viewing an infographic about science appeared to cause a small aggregate increase in trust in science, which may have, in turn, reduced the believability of COVID-19 misinformation. The effect sizes were small but commensurate with our 60-second, highly scalable intervention approach. Researchers should study the potential for truthful messaging about how science works to serve as misinformation inoculation and test how best to do so. TRIAL REGISTRATION: NCT04557241; https://clinicaltrials.gov/ct2/show/NCT04557241. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/24383.

Using infographics to improve trust in science: a randomized pilot test.

OBJECTIVE: This study describes the iterative process of selecting an infographic for use in a large, randomized trial related to trust in science, COVID-19 misinformation, and behavioral intentions for non-pharmaceutical prevenive behaviors. Five separate concepts were developed based on underlying subcomponents of 'trust in science and scientists' and were turned into infographics by media experts and digital artists. Study participants (n = 100) were recruited from Amazon's Mechanical Turk and randomized to five different arms. Each arm viewed a different infographic and provided both quantitative (narrative believability scale and trust in science and scientists inventory) and qualitative data to assist the research team in identifying the infographic most likely to be successful in a larger study. RESULTS: Data indicated that all infographics were perceived to be believable, with means ranging from 5.27 to 5.97 on a scale from one to seven. No iatrogenic outcomes were observed for within-group changes in trust in science. Given equivocal believability outcomes, and after examining confidence intervals for data on trust in science and then the qualitative responses, we selected infographic 3, which addressed issues of credibility and consensus by illustrating changing narratives on butter and margarine, as the best candidate for use in the full study.

Botched Ebola Vaccine Trials in Ghana: An Analysis of Discourses in the Media.

In June 2015, proposed Ebola vaccine trials were suspended by the Ministry of Health of Ghana amid protests from members of parliament and the general public. Scholarship has often focused on the design, development, and administration of vaccines. Of equal importance are the social issues surrounding challenges with vaccine trials and their implementation. The purpose of this study was to analyze discourses in the media that led to the suspension of the 2015 Ebola vaccine trials in Ghana. I use a sociological lens drawing on moral panic and risk society theories. The study qualitatively analyzed discourses in 18 semi-structured interviews with media workers, selected online publications, and user comments about the Ebola vaccine trials. The findings show that discourses surrounding the Ebola vaccine trials drew on cultural, biomedical, historical, and even contextual knowledge and circumstances to concretize risk discourses and garner support for their positions. Historical, political, and cultural underpinnings have a strong influence on biomedical practices and how they are (not) accepted. This study highlights the complexity and challenges of undertaking much needed vaccine tests in societies where the notion of drug trials has underlying historical and sociological baggage that determine whether (or not) the trials proceed.

Advocacy and Mobilizing for Health Policy Change: Ghanaian News Media's Framing of a Prescription Opioid Crisis.

In Ghana, the year 2018 saw many news articles about the youth, market women, and students increasingly abusing two opioids: tramadol and codeine-containing cough syrups. Our study examines Ghanaian news media framing of the opioid abuse crisis in Ghana to determine if and how the amount and framing of media coverage may have helped push the issue onto the policy agenda. We content analyzed all available online versions of print media coverage of news stories about tramadol and or codeine coverage in Ghana. Findings revealed the predominant and consistent use of the policy frame, societal attribution of responsibility, reliance on expert sources, and the inclusion of mobilizing information. We argue that the news media's talk about the health crisis as a policy issue might not only offer specific solutions, but also perform an advocacy function by mobilizing various stakeholders as conversation partners to act.

COVID-19 Misinformation Prophylaxis: Protocol for a Randomized Trial of a Brief Informational Intervention.

BACKGROUND: As the COVID-19 pandemic continues to affect life in the United States, the important role of nonpharmaceutical preventive behaviors (such as wearing a face mask) in reducing the risk of infection has become clear. During the pandemic, researchers have observed the rapid proliferation of misinformed or inconsistent narratives about COVID-19. There is growing evidence that such misinformed narratives are associated with various forms of undesirable behavior (eg, burning down cell towers). Furthermore, individuals' adherence to recommended COVID-19 preventive guidelines has been inconsistent, and such mandates have engendered opposition and controversy. Recent research suggests the possibility that trust in science and scientists may be an important thread to weave throughout these seemingly disparate components of the modern public health landscape. Thus, this paper describes the protocol for a randomized trial of a brief, digital intervention designed to increase trust in science. OBJECTIVE: The objective of this study is to examine whether exposure to a curated infographic can increase trust in science, reduce the believability of misinformed narratives, and increase the likelihood to engage in preventive behaviors. METHODS: This is a randomized, placebo-controlled, superiority trial comprising 2 parallel groups. A sample of 1000 adults aged ≥18 years who are representative of the population of the United States by gender, race and ethnicity, and age will be randomly assigned (via a 1:1 allocation) to an intervention or a placebo-control arm. The intervention will be a digital infographic with content based on principles of trust in science, developed by a health communications expert. The intervention will then be both pretested and pilot-tested to determine its viability. Study outcomes will include trust in science, a COVID-19 narrative belief latent profile membership, and the likelihood to engage in preventive behaviors, which will be controlled by 8 theoretically selected covariates. RESULTS: This study was funded in August 2020, approved by the Indiana University Institutional Review Board on September 15, 2020, and prospectively registered with ClinicalTrials.gov. CONCLUSIONS: COVID-19 misinformation prophylaxis is crucial. This proposed experiment investigates the impact of a brief yet actionable intervention that can be easily disseminated to increase individuals' trust in science, with the intention of affecting misinformation believability and, consequently, preventive behavioral intentions. TRIAL REGISTRATION: ClinicalTrials.gov NCT04557241; https://clinicaltrials.gov/ct2/show/NCT04557241. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/24383.