Defining Misinformation and Related Terms in Health-Related Literature: Scoping Review.

BACKGROUND: Misinformation poses a serious challenge to clinical and policy decision-making in the health field. The COVID-19 pandemic amplified interest in misinformation and related terms and witnessed a proliferation of definitions. OBJECTIVE: We aim to assess the definitions of misinformation and related terms used in health-related literature. METHODS: We conducted a scoping review of systematic reviews by searching Ovid MEDLINE, Embase, Cochrane, and Epistemonikos databases for articles published within the last 5 years up till March 2023. Eligible studies were systematic reviews that stated misinformation or related terms as part of their objectives, conducted a systematic search of at least one database, and reported at least 1 definition for misinformation or related terms. We extracted definitions for the terms misinformation, disinformation, fake news, infodemic, and malinformation. Within each definition, we identified concepts and mapped them across misinformation-related terms. RESULTS: We included 41 eligible systematic reviews, out of which 32 (78%) reviews addressed the topic of public health emergencies (including the COVID-19 pandemic) and contained 75 definitions for misinformation and related terms. The definitions consisted of 20 for misinformation, 19 for disinformation, 10 for fake news, 24 for infodemic, and 2 for malinformation. "False/inaccurate/incorrect" was mentioned in 15 of 20 definitions of misinformation, 13 of 19 definitions of disinformation, 5 of 10 definitions of fake news, 6 of 24 definitions of infodemic, and 0 of 2 definitions of malinformation. Infodemic had 19 of 24 definitions addressing "information overload" and malinformation had 2 of 2 definitions with "accurate" and 1 definition "used in the wrong context." Out of all the definitions, 56 (75%) were referenced from other sources. CONCLUSIONS: While the definitions of misinformation and related terms in the health field had inconstancies and variability, they were largely consistent. Inconstancies related to the intentionality in misinformation definitions (7 definitions mention "unintentional," while 5 definitions have "intentional"). They also related to the content of infodemic (9 definitions mention "valid and invalid info," while 6 definitions have "false/inaccurate/incorrect"). The inclusion of concepts such as "intentional" may be difficult to operationalize as it is difficult to ascertain one's intentions. This scoping review has the strength of using a systematic method for retrieving articles but does not cover all definitions in the extant literature outside the field of health. This scoping review of the health literature identified several definitions for misinformation and related terms, which showed variability and included concepts that are difficult to operationalize. Health practitioners need to exert caution before labeling a piece of information as misinformation or any other related term and only do so after ascertaining accurateness and sometimes intentionality. Additional efforts are needed to allow future consensus around clear and operational definitions.

Media Exposure and Health Behavior during Pandemics: The Mediating Effect of Perceived Knowledge and Fear on Compliance with COVID-19 Prevention Measures.

Emerging research has examined the role of media coverage of diseases in influencing people's health behavior, particularly their compliance with prevention measures. This study examines whether increased media exposure to COVID-19 news and interpersonal communication about the disease positively relate to people's abidance by prevention measures, and whether perceived knowledge and fear mediate this relationship. The study focuses on Lebanon, whose government and media responses led to a successful containment of COVID-19 in its first phase, although the country was experiencing a severe economic crisis, widespread political unrest, and a massive influx of refugees. It examines both legacy media (Television) and social media, as well as interpersonal communication, through a cross-sectional researcher-administered phone survey of 1,536 adults and a nationally representative probability sample. The fieldwork was conducted between March 27 and April 23, 2020, and resulted in a 51.6% response rate. The findings support the hypotheses that increased media exposure to COVID-19 news positively relates to people's abidance by prevention measures and that perceived knowledge and fear mediate this relationship. However, the same hypotheses for interpersonal communication were not supported.

Media exposure, mediated social comparison to idealized images of muscularity, and anabolic steroid use.

This study examined the association between anabolic-androgenic steroid (AAS) use and dominant sociocultural factors, specifically media exposure to idealized images of male muscularity, and mediated social comparison trends among a sample of young Arab adults. The study found evidence that participants more exposed to content that promotes muscularity and those who idealize images of muscularity and perceive them as motivators for achieving muscularity are more likely to be AAS users. It also found that a significant percentage of participants used at least one kind of dietary supplement and that the level of AAS use among health club participants indicates it is a significant public health problem in Lebanon. The study suggests that dealing with this problem requires a unique approach, beyond the typical awareness of risks strategy, since some users were well aware of the risks yet continue to use AAS, and their motivations pertain more to body image and sexuality. A stronger approach that utilizes critical media literacy teaching that ingrains these issues into school and university curricula will have a more lasting impact.

Lebanese adolescents' expectations about social inclusion of peers in intergroup contexts.

This study examined the role of group norms, group identity, age, contact, and stereotypes on youths' decisions to include a peer in an intergroup context portraying Lebanese and American adolescents. Lebanese participants (N = 275), ages 12 and 16 years, were surveyed about expectations for inclusion of an out-group target with similar interests or an in-group target with different interests into their own Lebanese group or another American group. Findings indicated participants focused on shared interests, rather than national identity, when making inclusion decisions for either group and group norms mattered. Older participants expected American peers to be less inclusive towards an out-group peer. Direct contact predicted inclusivity of out-group American peers into one's own Lebanese group, and indirect media-based contact predicted expectations for inclusivity into an American out-group. Findings have implications for interventions aimed at improving cross-national friendships which, in turn, have the potential to reduce prejudicial attitudes.

Mobile device use among emergency department healthcare professionals: prevalence, utilization and attitudes.

Mobile devices are increasingly permeating healthcare and are being regularly used by healthcare providers. We examined the prevalence and frequency of mobile device use, and perceptions around clinical and personal usage, among healthcare providers (attending physicians, residents, and nurses) in the Emergency Department (ED) of a large academic medical center in Lebanon. Half of the target population (N = 236) completed the cross-sectional electronic questionnaire. Mobile device usage for personal matters was uniform across all providers, with the highest usage reported by medical students (81.3%) and lowest by attendings (75.0%). Medical formulary/drug referencing applications were the most common application used by providers followed by disease diagnosis/management applications, 84.4% and 69.5% respectively. Most respondents agreed that mobile devices enabled better-coordinated care among providers and were beneficial to patient care. Most respondents also agreed that mobile device use assisted in quickly resolving personal issues and reduced their feeling of stress, yet the majority did not feel that personal usage improved performance at work. Study findings revealed that although healthcare providers value mobile devices' positive impact on coordination of care, the reverse spillover effect of personal issues into the workplace enabled by mobile devices might have some negative impact on performance of staff at work.

Mitigating infodemics: The relationship between news exposure and trust and belief in COVID-19 fake news and social media spreading.

INTRODUCTION: Misinformation surrounding COVID-19 poses a global public health problem that adversely affects governments' abilities to mitigate the disease and causes accidental deaths and self-harm due to false beliefs about the virus, prevention measures, vaccines and cures. We aim to examine the relationship between exposure to and trust in COVID-19 news (from Television, social media, interpersonal communication) and information sources (healthcare experts, government, clerics) and belief in COVID-19 myths and false information, as well as critical verification practices before posting on social media. METHODS: We use a cross-sectional researcher-administered phone survey of adults living in Lebanon between March 27 and April 23, 2020. RESULTS: The sample included 56.1% men and 43.9% women, 37.9% with a university degree, 63.0% older than 30, and 7% with media literacy training. Those who trust COVID-19 news from social media [95%CI:(1.05-1.52)] and interpersonal communication [95%CI:(1.25-1.82)], and those who trust information from clerics [95%CI:(1.25-1.82)] were more likely to believe in COVID-19 myths and false information. University graduates [95%CI:(0.25-0.51)] and those who trust information from government [95%CI:(0.65-0.89] were less likely to believe in myths and false information. Those who believe in COVID-19 myths and false information [95%CI:(0.25-0.70)] were less likely to engage in critical social media posting practices. Only those who underwent media literacy training [95%CI:(1.24-6.55)] were more likely to engage in critical social media posting practices. CONCLUSION: Higher education and trust in information from government contributed to decreasing belief in COVID-19 myths and false information. Trust in news from social media, interpersonal communication and clerics contributed to increasing belief in COVID-19 myths and false information, which in turn contributed to less critical social media posting practices, thereby exacerbated the infodemic. Media literacy training contributed to increasing critical social media posting practices, thereby played a role in mitigating the infodemic.

The extent, nature, and nutritional quality of foods advertised to children in Lebanon: the first study to use the WHO nutrient profile model for the Eastern Mediterranean Region.

OBJECTIVE: Exposure to food marketing may influence children's food preferences and consumption patterns and may increase the risk of childhood obesity. The WHO Office for the Eastern Mediterranean Region (EMR) has recently released a regional nutrient profile model (WHO EMR) for the purpose of regulating the marketing of food and beverages to children. This study aimed at 1) analyzing the frequency and types of food and drink advertisements during children's viewing time in Lebanon; 2) examining the nutritional content of the advertised food products in reference to the nutrient thresholds specified by the WHO EMR model; and 3) assessing the proportion of food advertisements that included health messages. DESIGN: This study consisted of a cross-sectional content analysis of food advertisements on local TV channels, during children's viewing time. SETTING: Three local Lebanese channels with the highest viewership among 4- to 14-year-olds were selected. Recorded broadcasts (September 2016 through January 2017) were analyzed between 3 pm and 10 pm on weekdays and between 8 am and 10 pm on weekend days. RESULTS: Approximately 31% of advertisements were for foods or drinks. The proportion of food advertisements was the highest during children's programs (43%) compared to general viewing (32%) and parental guidance (29%) programs. Approximately 8 out of 10 food advertisements were for products that did not meet the standards of the WHO EMR model. Of concern was the heavy advertisement of alcoholic beverages during programs for general audiences. The majority of the advertisements that comprised a health claim were for foods that did not meet the WHO EMR's nutritional standards (79%). CONCLUSIONS: The findings of this study, which is the first to utilize the new WHO EMR profile model, should be viewed as a foundation for the development of food marketing policies aimed at reducing children's exposure to TV food advertisements in Lebanon, a country that harbors a high burden of childhood obesity.

Using media to impact health policy-making: an integrative systematic review.

INTRODUCTION: Media interventions can potentially play a major role in influencing health policies. This integrative systematic review aimed to assess the effects of planned media interventions-including social media-on the health policy-making process. METHODS: Eligible study designs included randomized and non-randomized designs, economic studies, process evaluation studies, stakeholder analyses, qualitative methods, and case studies. We electronically searched Medline, EMBASE, Communication and Mass Media Complete, Cochrane Central Register of Controlled Trials, and the WHO Global Health Library. We followed standard systematic review methodology for study selection, data abstraction, and risk of bias assessment. RESULTS: Twenty-one studies met our eligibility criteria: 10 evaluation studies using either quantitative (n = 7) or qualitative (n = 3) designs and 11 case studies. None of the evaluation studies were on social media. The findings of the evaluation studies suggest that media interventions may have a positive impact when used as accountability tools leading to prioritizing and initiating policy discussions, as tools to increase policymakers' awareness, as tools to influence policy formulation, as awareness tools leading to policy adoption, and as awareness tools to improve compliance with laws and regulations. In one study, media-generated attention had a negative effect on policy advocacy as it mobilized opponents who defeated the passage of the bills that the media intervention advocated for. We judged the confidence in the available evidence as limited due to the risk of bias in the included studies and the indirectness of the evidence. CONCLUSION: There is currently a lack of reliable evidence to guide decisions on the use of media interventions to influence health policy-making. Additional and better-designed, conducted, and reported primary research is needed to better understand the effects of media interventions, particularly social media, on health policy-making processes, and the circumstances under which media interventions are successful. TRIAL REGISTRATION: PROSPERO 2015: CRD42015020243.