Assessing the Effect of Nonvisual Information Factors in Pandemic-Related Video Communication: Randomized Controlled Between-Subjects Experiment.

BACKGROUND: Videos have been an important medium for providing health and risk communication to the public during the COVID-19 pandemic. Public health officials, health care professionals, and policy makers have used videos to communicate pandemic-related content to large parts of the population. Evidence regarding the outcomes of such communication, along with their determinants, is however limited. OBJECTIVE: The aim of this study was to test the impact of nonvisual information factors of video communication on 4 outcomes: trust, comprehension, intentions, and behavior. METHODS: Twelve short health communication videos related to pandemics were produced and shown to a large sample of participants, applying a randomized controlled between-subjects design. Three factors were included in the creation of the videos: the topic (exponential growth, handwashing, and burden of pandemics on the health care system), the source (expert and nonexpert), and a call to action (present or absent). Participants were randomly assigned to 1 video intervention, and 1194 valid replies were collected. The data were analyzed using factorial ANOVA. RESULTS: The 3 pandemic-related topics did not affect trust, comprehension, intentions, or behavior. Trust was positively influenced by an expert source (2.5%), whereas a nonexpert source instead had a positive effect on the proxy for behavior (5.7%) compared with the expert source. The inclusion of a call to action had a positive effect on both trust (4.1%) and comprehension (15%). CONCLUSIONS: Trust and comprehension in pandemic-related video communication can be enhanced by using expert sources and by including a call to action, irrespective of the topic being communicated. Intentions and behavior appear to be affected to a small extent by the 3 factors tested in this study. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/34275.

Misleading graphs in context: Less misleading than expected.

Misleading graphs are a source of misinformation that worry many experts. Especially people with a low graph literacy are thought to be persuaded by graphs that misrepresent the underlying data. But we know little about how people interpret misleading graphs and how these graphs influence their opinions. In this study we focus on the effect of truncating the y-axis for a line chart which exaggerates an upgoing trend. In a randomized controlled trial, we showed participants either a normal or a misleading chart, and we did so in two different contexts. After they had seen the graphs, we asked participants their opinion on the trend and to give an estimation of the increase. Finally we measured their graph literacy. Our results show that context is the only significant factor in opinion-forming; the misleading graph and graph literacy had no effect. None of these factors had a significant impact on estimations for the increase. These results show that people might be less susceptible to misleading graphs than we thought and that context has more impact than a misleading y-axis.

Animal biodiversity and specificity in children's picture books.

While animal biodiversity is declining globally, cultural representations of animals are highly prevalent in society and play an increasing part in shaping children's perceptions of animal diversity. We studied animal portrayals in children's picture books in the Netherlands, and coded over 2,200 animals from 217 award-winning books. We found a strong bias toward vertebrates, mammals in particular. Mammals were featured more often than other animals, played more prominent roles in the story, and were visually and textually specified more strongly. Furthermore, exotic and domestic species outnumbered native species. Picture books currently are likely to reinforce children's perceptions toward only a small part of animal biodiversity. While we realize that picture books have other primary aims, picture book makers could be inspired and encouraged to diversify and specify their portrayals of the natural world. This would broaden children's perceptions of the animal kingdom and could help foster lasting connections to biodiversity.

Species identification skills predict in-depth knowledge about species.

To raise biodiversity awareness effectively, communicators should be aware of knowledge levels in their audiences. Species identification skills have been used in the past as a measure of what people know about species, yet it is not known whether they serve as good indicators. To study the link between species identification and in-depth species knowledge, we presented an animal knowledge test to an online audience of over 7,000 Dutch adults, and used correlation and regression analyses to determine the extent to which species identification predicts in-depth knowledge about species' origin, habitat, diet, and behavior. We found that in-depth knowledge was higher in those who correctly identified species as compared with those who did not correctly identify species, for all four types of in-depth knowledge. Moreover, as compared to alternative variables (work, age, gender, and educational level), species identification was by far the best predictor for in-depth knowledge about species. However, species identification levels were generally higher than levels of in-depth knowledge, and knowledge gaps and misconceptions were uncovered. The results confirm the value of species identification tests, but also highlight limitations and challenges that should be taken into account when establishing knowledge levels and communicating biodiversity.

Creating Effective, Evidence-Based Video Communication of Public Health Science (COVCOM Study): Protocol for a Sequential Mixed Methods Effect Study.

BACKGROUND: The nonlinear nature of contagious diseases and the potential for exponential growth can be difficult to grasp for the general public. This has strong implications for public health communication, which needs to be both easily accessible and efficient. A pandemic is an extreme situation, and the accompanying strict societal measures are generally easier to accept if one understands the underlying reasoning behind them. Bringing about informed attitude change and achieving compliance to strict restrictions requires explanations of scientific concepts and terminologies that laypersons can understand. OBJECTIVE: The aim of the project is to develop effective, evidence-based modes of video communication for translating complex, but important, health messages about pandemics to both the general population and decision makers. The study uses COVID-19 as a case to learn and prepare society for handling the ongoing and future pandemics, as well as to provide evidence-based tools for the science communication toolbox. METHODS: The project applies a mixed methods design, combining qualitative methods (eg, interviews, observational studies, literature reviews) and quantitative methods (eg, randomized controlled trials [RCTs]). The project brings together researchers from a wide range of academic fields, as well as communication industry professionals. RESULTS: This study has received funding from the Trond Mohn Foundation through the Research Council of Norway's "COVID-19 Emergency Call for Proposals" March 2020. Recruitment and data collection for the exploratory first phase of the project ran from February 2021 to March 2021. Creative communication work started in May 2021, and the production of videos for use in the RCTs in the final phase of the project started in September 2021. CONCLUSIONS: The COVCOM project will take on several grand challenges within the field of communicating science and provide evidence-based tools to the science communication toolbox. A long-term goal of the project is to contribute to the creation of a more resilient health care system by developing communication responses tailormade for different audiences, preparing society for any future pandemic. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/34275.

What Should Clinicians Tell Patients about Placebo and Nocebo Effects? Practical Considerations Based on Expert Consensus.

INTRODUCTION: Clinical and laboratory studies demonstrate that placebo and nocebo effects influence various symptoms and conditions after the administration of both inert and active treatments. OBJECTIVE: There is an increasing need for up-to-date recommendations on how to inform patients about placebo and nocebo effects in clinical practice and train clinicians how to disclose this information. METHODS: Based on previous clinical recommendations concerning placebo and nocebo effects, a 3-step, invitation-only Delphi study was conducted among an interdisciplinary group of internationally recognized experts. The study consisted of open- and closed-ended survey questions followed by a final expert meeting. The surveys were subdivided into 3 parts: (1) informing patients about placebo effects, (2) informing patients about nocebo effects, and (3) training clinicians how to communicate this information to the patients. RESULTS: There was consensus that communicating general information about placebo and nocebo effects to patients (e.g., explaining their role in treatment) could be beneficial, but that such information needs to be adjusted to match the specific clinical context (e.g., condition and treatment). Experts also agreed that training clinicians to communicate about placebo and nocebo effects should be a regular and integrated part of medical education that makes use of multiple formats, including face-to-face and online modalities. CONCLUSIONS: The current 3-step Delphi study provides consensus-based recommendations and practical considerations for disclosures about placebo and nocebo effects in clinical practice. Future research is needed on how to optimally tailor information to specific clinical conditions and patients' needs, and on developing standardized disclosure training modules for clinicians.

Expert quotes and exaggeration in health news: a retrospective quantitative content analysis.

Background This research is an investigation into the role of expert quotes in health news, specifically whether news articles containing a quote from an independent expert are less often exaggerated than articles without such a quote. Methods Retrospective quantitative content analysis of journal articles, press releases, and associated news articles was performed. The investigated sample are press releases on peer-reviewed health research and the associated research articles and news stories. Our sample consisted of 462 press releases and 668 news articles from the UK (2011) and 129 press releases and 185 news articles from The Netherlands (2015). We hand-coded all journal articles, press releases and news articles for correlational claims, using a well-tested codebook. The main outcome measures are types of sources that were quoted and exaggeration of correlational claims. We used counts, 2x2 tables and odds ratios to assess the relationship between presence of quotes and exaggeration of the causal claim. Results Overall, 99.1% of the UK press releases and 84.5% of the Dutch press releases contain at least one quote. For the associated news articles these percentages are: 88.6% in the UK and 69.7% in the Netherlands. Authors of the study are most often quoted and only 7.5% of UK and 7.0% of Dutch news articles contained a new quote by an expert source, i.e. one not provided by the press release. The relative odds that an article without an external expert quote contains an exaggeration of causality is 2.6. Conclusions The number of articles containing a quote from an independent expert is low, but articles that cite an external expert do contain less exaggeration.

Exaggerated health news: association between exaggeration in university press releases and exaggeration in news media coverage / Overdreven gezondheidsnieuws

Objective: To determine how often press releases and news articles contain exaggeration and to locate its origin in the trajectory from research paper to news article. Design: Retrospective quantitative content analysis. Method: We analysed press releases on health-related research published by Dutch universities and university medical centres in 2015 (n = 129) as well as news media articles related to those press releases (n = 185). Results: 20% of press releases and 29% of news articles exaggerated the conclusion or causal claim. Explicit health advice was, when present, exaggerated in 7% of press releases and 10% of news articles. When press releases exaggerated the conclusion or causal claim, 92% of associated news articles contained the same exaggeration. When the conclusion was not exaggerated in the press release, 6% of the news articles was exaggerated. The relative chance for exaggerated news associated with exaggerated press releases was 16.08 (95% CI: 7.35-35.18). Exaggerated press releases were associated with news articles more frequently. The relative chance for news articles to be associated with exaggerated press releases vs. a non-exaggerated press release was 1.45 (95% CI: 1.02-2.04). Conclusion: Exaggeration in health-related news is strongly correlated with exaggeration in the original press release and occurs in more than 1 in 5 articles. Monitoring and, if necessary, improving the accuracy and correctness of academic press releases seem to be important measures to improve the quality of health related news.Conflict of interest and financial support: I. Smeets is a columnist with one of the newspapers investigated. She was not involved in collecting, coding and analysing the relevant data. Additional potential conflicts of interest have been reported for this article. ICMJE forms provided by the authors are available online along with the full text of this article.