Effects of Exposure to Conflicting Health Information on Topic-Specific Information Sharing and Seeking Intentions.

Despite considerable evidence that exposure to conflicting health information can have undesirable effects on outcomes including public understanding about and trust in health recommendations, comparatively little is known about whether such exposure influences intentions to engage in two communication behaviors central to public health promotion: information sharing and information seeking. The purpose of the current study is to test whether exposure to conflicting information influences intentions to share and seek information about six health topics. We analyzed data from two waves of a longitudinal survey experiment with a nationally representative sample of U.S. adults (N = 3,920). Participants were randomly assigned to either a conflict or no-conflict message condition, in which they read news stories and social media posts about three (of six) randomly selected health topics at Time 1 and the remaining three at Time 2. The dependent variables, which were measured at Time 2, asked participants whether they intended to share or seek information about the three topics they had just viewed. Linear mixed effects models showed that exposure to conflict reduced intentions to share and seek information, regardless of health topic. These findings suggest that exposure to conflicting health information discourages two important types of health information engagement, thus adding to the growing evidence base documenting the adverse consequences of conflicting information for public health.

Effects of Exposure to Conflicting Information About Mammography on Cancer Information Overload, Perceived Scientists' Credibility, and Perceived Journalists' Credibility.

Conflicting recommendations about mammography screening have received ample media coverage, emphasizing scientists' debate over the value of breast cancer screening and differences in professional organizations' guidelines about the appropriate starting age and frequency of routine mammograms. Whereas past research suggests that exposure to such media coverage of conflicting recommendations can have undesirable consequences, both on topic-specific (e.g., ambivalence about mammography) and more general outcomes (e.g., backlash toward cancer prevention recommendations), experimental evidence, especially for effects on more general health cognitions, is limited. Using data from a population-based sample of U.S. women aged 35-55 years (N = 1467), the current study experimentally tested whether exposure to news stories that varied in the level of conflict about mammography (no, low, medium, and high conflict) affected three general health cognitions-cancer information overload (CIO), perceived scientists' credibility, and perceived journalists' credibility. We further tested whether these effects varied by research literacy. Results showed that exposure to conflict increased women's perceived CIO and reduced their perceptions of journalists' credibility, and that these effects tapered off at higher levels of conflict. Exposure to conflict also reduced perceptions of scientists' credibility, but only among participants with lower levels of research literacy. Directions for future research and implications for mitigating these potentially adverse effects on public health are discussed.

Effects of Prior Exposure to Conflicting Health Information on Responses to Subsequent Unrelated Health Messages: Results from a Population-Based Longitudinal Experiment.

BACKGROUND: Accumulating evidence suggests that exposure to conflicting health information can adversely affect public understanding of and trust in health recommendations. What is not known is whether prior exposure to such information renders people less receptive to subsequent unrelated health messages about behaviors for which the evidence is clear and consistent. PURPOSE: This study tests this "carryover" effects hypothesis, positing that prior exposure to conflict will reduce receptivity to subsequent unrelated health messages, and examines potential affective and cognitive pathways through which such effects might occur. METHODS: A three-wave, online, population-based survey experiment (N = 2,716) assessed whether participants who were randomly assigned to view a series of health news stories and social media posts featuring conflict at Times 1 and 2 were ultimately less receptive at Time 3 to ads from existing health campaigns about behaviors for which there is scientific consensus, compared to those who saw the same series of stories and posts that did not feature conflict. RESULTS: Structural equation modeling revealed evidence of carryover effects of exposure to conflict on two dimensions of message receptivity: greater resistance to the unrelated ads and lower perceptions of the health behaviors featured in the ads. Modeling indicated that carryover effects were a function of generalized backlash toward health recommendations and research elicited by prior exposure to conflicting information. CONCLUSIONS: Findings suggest that the broader public information environment, which is increasingly characterized by messages of conflict and controversy, could undermine the success of large-scale public health messaging strategies.

Effects of Media Exposure to Conflicting Information About Mammography: Results From a Population-based Survey Experiment.

BACKGROUND: Although there is growing theoretical and empirical support for the proposition that media exposure to conflicting health information negatively influences public understanding and behavior, few studies have causally linked exposure to conflict with undesirable outcomes. Such outcomes might be particularly likely in the context of mammography, given widespread media attention to conflicting recommendations about the age at and frequency with which average-risk women should be screened for breast cancer. PURPOSE: The current study tests whether exposure to conflicting information about mammography negatively influences women's affective and cognitive responses and examines whether effects vary by socioeconomic position. METHODS: We conducted an online survey experiment in 2016 with a population-based sample of U.S. women aged 35-55 (N = 1,474). Participants were randomly assigned to one of four conditions that differed in the level of conflict about mammography presented in a news story (no, low, medium, or high conflict), stratifying by poverty level. RESULTS: Greater exposure to conflict increased women's negative emotional responses to the story they read, their confusion about and backlash toward cancer prevention recommendations and research, and their ambivalence about mammography and other types of cancer screening, though ambivalence leveled off at high levels of exposure. There was little evidence that effects varied across socioeconomic position. CONCLUSIONS: Findings add to the growing evidence base documenting undesirable outcomes of exposure to conflicting health information. Future research should examine whether the negative affective and cognitive responses observed translate into behavior, which could have implications for both health campaigns and patient-provider communication.

Affective and executive network processing associated with persuasive antidrug messages.

Previous research has highlighted brain regions associated with socioemotional processes in persuasive message encoding, whereas cognitive models of persuasion suggest that executive brain areas may also be important. The current study aimed to identify lateral prefrontal brain areas associated with persuasive message viewing and understand how activity in these executive regions might interact with activity in the amygdala and medial pFC. Seventy adolescents were scanned using fMRI while they watched 10 strongly convincing antidrug public service announcements (PSAs), 10 weakly convincing antidrug PSAs, and 10 advertisements (ads) unrelated to drugs. Antidrug PSAs compared with nondrug ads more strongly elicited arousal-related activity in the amygdala and medial pFC. Within antidrug PSAs, those that were prerated as strongly persuasive versus weakly persuasive showed significant differences in arousal-related activity in executive processing areas of the lateral pFC. In support of the notion that persuasiveness involves both affective and executive processes, functional connectivity analyses showed greater coactivation between the lateral pFC and amygdala during PSAs known to be strongly (vs. weakly) convincing. These findings demonstrate that persuasive messages elicit activation in brain regions responsible for both emotional arousal and executive control and represent a crucial step toward a better understanding of the neural processes responsible for persuasion and subsequent behavior change.

Vulnerability to the Effects of Conflicting Health Information: Testing the Moderating Roles of Trust in News Media and Research Literacy.

BACKGROUND: Exposure to conflicting health information can produce negative affective and cognitive responses, including confusion and backlash, and the effects of this exposure can even "carry over" and reduce people's receptivity to subsequent messages about health behaviors for which there is scientific consensus. What is not known is whether certain population subgroups are more vulnerable to such carryover effects. AIMS: This study investigates whether carryover effects of exposure to conflicting information are moderated by two factors, trust in news media and research literacy, testing the hypothesis that lower trust and higher literacy could protect against such effects. METHOD: The analysis draws on data from a longitudinal population-based experiment (N = 2,716), in which participants were randomly assigned to view health news stories and social media posts that either did or did not feature conflicting information, and subsequently exposed to ads from existing health campaigns about behaviors for which there is scientific consensus. Structural equation modeling was used to test study hypotheses. RESULTS: Neither lower trust in news media nor higher research literacy protected against carryover effects, as effects were observed across levels of both trust and literacy. Although level of research literacy did not affect whether carryover effects were observed, it did shape how those effects emerged. CONCLUSION: The public, regardless of their level of trust in news media or research literacy, is vulnerable to the downstream effects of exposure to conflicting health information. Targeted health communication interventions are needed to improve messaging about evolving science and, in turn, increase receptivity to public health recommendations.

Sustaining positive perceptions of science in the face of conflicting health information: An experimental test of messages about the process of scientific discovery.

BACKGROUND: The public is often exposed to conflicting health information, with evidence of concerning consequences, yet little attention has been paid to identifying strategies that can mitigate its effects. OBJECTIVE: The current study tests whether three different approaches to communicating about the process of scientific discovery-a rational appeal using analogical evidence, a rational appeal using testimonial evidence, and a logic-based inoculation approach-could reduce the adverse effects of exposure to conflict by positively framing how people construe the scientific process, increasing their perceived knowledge about the scientific process, and helping them to respond to critiques about the scientific process, which, in turn, might make them less apt to counterargue the science they subsequently encounter in health news stories and other exposures to conflict. METHODS: We fielded a survey experiment in May 2022 with a national sample of U.S. adults (N = 1604). RESULTS: Providing any of the three messages about science prior to exposure to conflicting health information encouraged both positive construal of science and greater science knowledge perceptions and discouraged counterarguing science, compared to a control condition in which people were only exposed to conflict. Of the three messaging approaches tested, the testimonial evidence message was slightly more effective, but was also considered slightly more accurate, credible, and trustworthy. CONCLUSIONS: Developing and implementing messages that describe the process of scientific discovery could prove successful, not only in improving public perceptions of science but perhaps ultimately in better equipping people to make sense of conflicting information and its causes. However, additional research on such strategies is needed, particularly as part of larger interventions with multiple messages across multiple exposures, if they are to have implications for health and science communication.

Affective antecedents of the perceived effectiveness of antidrug advertisements: an analysis of adolescents' momentary and retrospective evaluations.

Perceived message effectiveness is often used as a diagnostic tool to determine whether a health message is likely to be successful or needs modification before use in an intervention. Yet, published research on the antecedents of perceived effectiveness is scarce and, consequently, little is known about why a message is perceived to be effective or ineffective. The present study's aim was to identify and test the affective antecedents of perceived effectiveness of antidrug television messages in a sample of 190 adolescents in the 15-19 year age range. Factor-analytical tests of retrospective message evaluation items suggested two dimensions of perceived effectiveness, one that contained items such as convincingness whereas the other contained pleasantness items. Using retrospective data as well as real time valence and arousal ratings, we found that arousal underlies perceived convincingness and valence underlies perceived pleasantness. The results indicated activation of appetitive and defensive motivational systems, which suggests a clear motivational component to the concept of perceived message effectiveness.

Public perceptions of conflicting information surrounding COVID-19: Results from a nationally representative survey of U.S. adults.

Conflicting information surrounding COVID-19 abounds, from disagreement over the effectiveness of face masks in preventing viral transmission to competing claims about the promise of certain treatments. Despite the potential for conflicting information about COVID-19 to produce adverse public health effects, little is known about whether the U.S. public notices this information, and whether certain population subgroups are particularly likely to do so. To address these questions, we fielded a nationally representative survey of U.S. adults in late April 2020 (N = 1,007). Results showed substantial self-reported exposure to conflicting information about COVID-19, with nearly 75% of participants reporting having recently heard such information from health experts, politicians, and/or others. Participants perceived disagreement across a range of COVID-19-related issues, though from politicians more than health experts. Factors including political affiliation, information source use, and personal experience with COVID-19 were associated with perceptions of disagreement. Future research should consider potential cognitive and behavioral consequences of such perceptions.

Understanding smoking cessation: the role of smokers' quit history.

Many studies have found smokers' quit history to correlate with quitting smoking, but little is known about the psychological processes explaining this relationship. This study uses the integrative model of behavioral prediction to examine how quit history affects quit intention. Data from 3,428 Dutch smokers demonstrate that quit history affects (a) beliefs about quitting and (b) the degree to which self-efficacy predicts quit intention. It seems that a relatively unsuccessful history of prior quit attempts reduces self-efficacy over quitting and strengthens the relationship of self-efficacy with the intention to quit. The results are used to call for more process-oriented research in order to advance our understanding of the relationship between quit history and quit intention.

The Role of Distal Variables in Behavior Change: Effects of Adolescents' Risk for Marijuana Use on Intention to Use Marijuana.

This study uses an integrative model of behavioral prediction as an account of adolescents' intention to use marijuana regularly. Adolescents' risk for using marijuana regularly is examined to test the theoretical assumption that distal variables affect intention indirectly. Risk affects intention indirectly if low-risk and high-risk adolescents differ on the strength with which beliefs about marijuana are held, or if they differ on the relative importance of predictors of intention. A model test confirmed that the effect of risk on intention is primarily indirect. Adolescents at low and high risk particularly differed in beliefs concerning social costs and costs to self-esteem. Not surprisingly, at-risk adolescents took a far more positive stand toward using marijuana regularly than did low-risk adolescents. On a practical level, the integrative model proved to be an effective tool for predicting intention to use marijuana, identifying key variables for interventions, and discriminating between target populations in terms of determinants of marijuana use.

Social influences on smoking cessation: a comparison of the effect of six social influence variables.

BACKGROUND: This study brings together the fragmentary knowledge on social influence factors related to smoking cessation. An inventory of social influence variables shows six social influence factors. With the exception of descriptive norm, most of these are rarely studied in the context of smoking cessation. METHODS: Regression analysis on the data of 2895 smokers was used to estimate the relative importance of social influence variables as predictors of intention. The moderating effect of quit history was studied by adding interaction terms to the regression analysis. RESULTS: The regression analysis shows that subjective norm and injunctive norm, that is, the social norms on what ought to be done, are more important than descriptive norms, that is, the perceived smoking and smoking cessation behavior of others. This holds especially for smokers whose past cessation attempts quickly failed. Most smokers think that it is acceptable to smoke in most social situations, but simultaneously think that other people approve it if they quit smoking. CONCLUSIONS: Results suggest that health campaigns should incite social interaction to increase smokers' awareness of social norms on the proper behavior. Also, studies into smoking cessation should take account of the various social influence factors outlined in this study.

The effectiveness of gateway communications in anti-marijuana campaigns.

Successful anti-marijuana messages can be hypothesized to have two types of effects, namely persuasion effects, that is, a change in people's beliefs about using marijuana, and priming effects, that is, a strengthened correlation between beliefs and associated variables such as attitude and intention. This study examined different sets of anti-drug advertisements for persuasion and priming effects. The ads targeted the belief that marijuana is a gateway to stronger drugs, a belief that is often endorsed by campaign planning officials and health educators. A sample of 418 middle and high school students was randomly assigned to a control video or one of three series of ads, two of which included the gateway message in either an explicit or implicit way. Results did not support the use of the gateway belief in anti-marijuana interventions. Whereas no clear persuasion or priming effects were found for any of the ad sequences, there is some possibility that an explicit gateway argument may actually boomerang. In comparison to the control condition, adolescents in the explicit gateway condition tended to agree less with the gateway message and displayed weaker correlations between anti-marijuana beliefs and their attitude toward marijuana use. The results suggest that the gateway message should not be used in anti-drug interventions.