Combating Health Misinformation _ VCU _ Sept 11 2024.pdf

This is a grand rounds lecture entitled, "Combating Health Misinformation", presented to the Department of Emergency Medicine at Virginia Commonwealth University by Dr. Michael A. Gisondi, Professor of Emergency Medicine at Stanford School of Medicine. September 11, 2024.

1. MICHAELA. GISONDI, MD (HE/HIM)
PROFESSOR ANDVICECHAIROFEDUCATION
DEPARTMENT OFEMERGENCY MEDICINE
ASSISTANT DEANFORACADEMICADVISING
STANFORD SCHOOL OFMEDICINE
COMBATING HEALTH
MISINFORMATION

2. @MikeGisondi
Presented to:
VCU Department of Emergency Medicine, Grand Rounds, September 11, 2024
I have no pertinent disclosuresto report, financial or otherwise.
Views are my own and not endorsed by Stanford University.
Learning Objectives:
At the end of this presentation, engaged participants will be able to:
1.1. Define the terms misinformation, disinformation, and infodemic.
2.2. Explain how to use motivational interviewing to address health misinformation with patients.
3.3. List the 5 steps to address health misinformation online.
4.4. Identify opportunities for resident scholarship about health misinformation.

4. Four Questions to Answer Today:
What is the impactof health misinformation?
What are best practicesfor addressing misinformation with your patients?
How can we leverage social mediato combat health misinformation?
What can your residency programsdo to address misinformation?

5. What is the impact of
health misinformation?

7. “ALTERNATIVE FACTS”

9. HEALTH MISINFORMATION

10. Vaccine Hesitancy
Vaccination Rates
Preventable Deaths

11. Vaccine Hesitancy
Vaccination Rates
Preventable Deaths

14. Unvaccinated people
are 3x more likely
to be Republican
NPR, 2021

15. Residents from
Trump-won counties in
2020: 3x more likely to
die from COVID
NPR, 2021

16. Post-vaccine
COVID-19 death rate
43% higher for
Republicans
JAMA Internal Medicine, 2023

17. Prolonged Pandemic
New Variants
Vaccine Fatigue
Mental Illness

19. Celebrities on Social Media
70% of Attention
20% of Misinformation

23. INFODEMIC:
TOO MUCH INFORMATION…
(1) confusion
(2) mistrust
(3) lengthens outbreaks
WHO

24. INFORMATION OVERLOAD
Decision-Making
Anxiety, Stress
Depression
Quality of Life

30. The Virginia Board of Medicine considers the dissemination of false or misleading
information related to the practice of medicine as unprofessional conduct. This
can include spreading misinformation about COVID-19, its treatments, or
vaccines.
Specific actions that could lead to disciplinary measures might include:
1.Promoting unproven treatments for COVID-19
2.Discouraging patients from getting vaccinated based on false claims
3.Spreading conspiracy theories about the origins or nature of the virus
4.Undermining public health measures like masking or social distancing
The board's actions could range from a formal reprimand to suspension or
revocation of a physician's medical license, depending on the severity and
persistence of the misinformation.

32. What is the impact of
health misinformation?
Impact:
Vaccine Hesitancy
Deaths
New Variants
Infodemic

33. What are best practices for
addressing misinformation
with your patients?

34. 7 TIPS

35. Spend Time with
Patients Deliberating Vaccines

37. Spend Time with
Patients Deliberating Vaccines
“Have you received other vaccines?”
“May I ask why not the COVID vaccine?”

38. Engage Patients
With Empathy
“I understand why you’re concerned.”
“May I share some information with you?”
“Thank you for letting me share what I know.”

40. Personalize
the Message
“Let’s focus on how the vaccine can help you.”
“You’re healthy, yet COVID can still make yousick.”
“The vaccine can prevent youfrom getting seriously sick.”
“Youwon’t need to worry as much.”

41. Describe How
Misinformation Happens
“I understand your worry about side effects.”
“The vaccine has been safely administered to half of the world.”
“Inevitably some people will get sick from another illness.”
“It doesn’t mean the vaccine causedthem to get sick.”

42. Learner-Centered
Educational Frameworks
▪Safe learning environments
▪Internal Learner Motivation
▪Scaffolding and Framing
▪Social Acceptability
Sheng et al. AEM ET. 2021

43. 6-Step Myth
Debunking Strategy
1.State the misinformation once.
2.Immediately state a fact.
3.Explain why the fallacy was once considered true.
4.Explain why we know it to be false.
5.Explain why the alternative is correct.
6.Close by stating the fact again.

44. 6-Step Myth
Debunking Strategy
1.The vaccine was made too quickly and its unsafe.
2.The vaccine is among the safest ever made.
3.Some worried that vaccine testing was rushed.
4.Vaccine was tested in an appropriately large population.
5.It has since been given safely to half the world.
6.The vaccine is among the safest ever made.

45. Make COVID-19
Vaccination Routine Health Care
DO: “You are overdue for your COVID-19 booster.”
“I order boosters for all my patients who are overdue.”
DON’T: “Would you like to get a COVID-19 shot today?”

46. What are best practices for
addressing misinformation
with your patients?
Motivational Interviewing:
Respectful Dialogue
Listen and Validate
Provide Facts
Patient Draws Conclusions

47. How can we leverage
social media to combat
health misinformation?

48. ENGAGING ONLINE

50. Healthcare Provider
Social Media Hesitancy
Physicians not using their platform =
Public health threat

51. Common Barriers to
Social Media Engagement
▪Lack of measurable outcomes
▪Harassment and bullying
▪Lack of institutional support
▪Lack of social media training

52. Facilitators of
Social Media Engagement
▪Misinformation training
▪Social media training
▪Building social media presence

54. 5-Step Method to Combat
Misinformation Online
1.Identify and Label Misinformation
2.Provide Correct Information
3.Reference a Source
4.Repeat the Correct Information
5.Respond Immediately

55. Things that mighthappen
after a COVID-19 vaccine

56. Fact
Fact repeated
Explanation
Reference
Falsehood

57. Falsehood
Fact
Explanation
Fact
Reference

58. Prebunking

59. Prebunking
Misinformation
1.Provide Correct Information
2.Identify and Label Misinformation
3.Explain the Fallacy
4.Repeat the Correct Information

61. Digital Brand
Confession
I Broke My
Twitter Rules
in 2020

62. A Stanford Conference on Social Media and COVID-19 Misinformation
August 26, 2021

65. The COVID-19 INFODEMIC:
COMPLEX and CONTRADICTORY INFORMATION…
(1)origins of the virus
(2)farcical treatment options
(3)lifesaving vaccines
Gisondi et al. JMIR. 2022

67. Engage patients online
Partner with:
Online influencers
Social media companies
Mass media

70. Engage in public health
education online
Use social media to connect to
new strategic partners

71. How can we leverage
social media to combat
health misinformation?
Use Your Platform:
Engage in Social Media
Identify Misinformation
Provide Facts
Partner with Stakeholders

72. What can your
residency program do to
address misinformation?

73. RESIDENCY OPPORTUNITIES

74. ("social media" [tw] OR "social media" [mesh] OR twitter [ti] OR Instagram
[ti] OR facebook[ti]) AND ("covid 19" [tw] OR covid [tw] OR covid19 [tw]
OR "ncov2019" [tw] OR "novel coronavirus" [tw] OR "sarscov2" [tw] OR
"sarscov-2" [tw] OR "ncov2019" [tw] OR sarscov2 [tw] OR (wuhan[tw]
AND coronavirus* [tw]) OR "corona virus*" [tw] OR "coronavirus disease
2019" [tw] OR "coronavirus disease 19" [tw] OR "2019 ncov" [tw] OR
2019nCoV [tw] OR "coronavirus 2" [tw] OR "Coronavirus"[Mesh:NoExp]
OR "SARS-CoV-2"[Mesh] OR "COVID-19 Testing"[Mesh] OR "COVID-19"
[mesh] OR "COVID-19 Vaccines"[Mesh] OR "Receptors,
Coronavirus"[Mesh] OR "Spike Glycoprotein, Coronavirus"[Mesh] OR
"SARS-CoV-2 variants" [Supplementary Concept]) AND ("Patient
Education as Topic"[Mesh] OR "Patient Education Handout" [Publication
Type] OR "health literacy" [tw] OR "patient education" [tw] OR "Health
Literacy"[Mesh] OR "Health Promotion"[Mesh])

76. Residents launched an
awareness campaign about
health inequities on Twitter

78. Residents filmed
60 TikToksabout COVID
600,000 views

79. Residents made health
infographics, videos in Chinese
WeChat group of 500 patients

81. JGME 2023, Sheng et al.

82. Provider-moderated
Online Health Communities
▪Disproportionately young people
▪High demand for health-related content
▪Susceptible to unreliable content

85. Educators and
Educational Institutions
▪Evidence-based Educational Programs
▪Information Literacy Metrics

86. Health Professionals
Healthcare Institutions
▪Proactively Engage with the Public
▪Use Technology to Share Information
▪Partner with Community Groups

87. Researchers
Research Institutions
▪Assess the Impact of Misinformation
▪Target Interventions to Communities
▪Evaluate Interventions and Policies

88. What can your
residency program do to
address misinformation?
Use Social Media in New Ways:
Support social media use
Develop new policies
Teach best practices
Find research opportunities

89. Surgeon General Murthy, 2021
“Limiting the spread of
health misinformation is a
moral and civic imperative
that will require a
whole-of-society effort.”

90. Thank You!
@MikeGisondi
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