Public health x factchecking - building a business case for health fact-checking

How fact-checkers can work with public health professionals to promote credible, accurate health information.

1. TINA D PURNAT Prajna Leadership Fellow and DrPH Student TH Chan School of Public Health, Harvard University Fellow of the Australasian Institute of Digital Health tinapurnat.com Making a business case for health fact-checking GlobalFact11, Sarajevo, BIH, June 2024 This presentation  © 2024 by  Tina D Purnat  is licensed under  Attribution- NonCommercial - ShareAlike 4.0 International        

2. How you can use this slide deck Thanks for your interest in this topic. I developed this deck to support public health efforts and have made it available for others to use it as well. I’ve made full effort to acknowledge sources of information and adaptation of slides from other people. You are welcome to adapt the slide deck as per the license below. Please make an effort to properly credit the efforts of others that you use. This presentation  © 2024 by  Tina D Purnat  is licensed under  Attribution- NonCommercial - ShareAlike 4.0 International         You are free to: Share  — copy and redistribute the material in any medium or format Adapt  — remix, transform, and build upon the material The licensor cannot revoke these freedoms as long as you follow the license terms. Under the following terms: Attribution  - You must give  appropriate credit  , provide a link to the license, and  indicate if changes were made  . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. NonCommercial   - You may not use the material for  commercial purposes  . ShareAlike   - If you remix, transform, or build upon the material, you must distribute your contributions under the  same license  as the original. No additional restrictions  - You may not apply legal terms or  technological measures  that legally restrict others from doing anything the license permits. Creator: https://www.linkedin.com/in/tinadpurnat/ Work is published at: https://tinapurnat.com

3. Infodemic management has been introduced as a new capacity in health emergency preparedness and response An infodemic is an overabundance of information, accurate or not, in the digital and physical space, accompanying an acute health event such as an outbreak or epidemic. Infodemic management is the systematic use of risk- and evidence-based analysis and approaches to promote a healthier information environment and resilience against infodemic impacts on health behaviours during health emergencies.

4. Vaccinations Alternative Medicine Nutrition and Diet Mental Health Sexual and Reproductive Health Chronic Diseases HIV/AIDS Cancer Exercise and Fitness Allergies and Intolerances Chronic Pain Substance Abuse Sleep Health Aging and Anti-Aging Genetic Testing and Personalized Medicine Environmental Health Health topic areas that are represented in health misinformation research: Harmful narratives are found in many areas of health

5. Vaccinations Alternative Medicine Nutrition and Diet Mental Health Sexual and Reproductive Health Chronic Diseases HIV/AIDS Cancer Exercise and Fitness Allergies and Intolerances Chronic Pain Substance Abuse Sleep Health Aging and Anti-Aging Genetic Testing and Personalized Medicine Environmental Health Harmful narratives are found in many areas of health Health topic areas that are represented in health misinformation research: Health topics covered by survey responding organizations before GlobalFact11. 41% (14) predict that health-fact-checks will increase and 41% (14) they will stay at same level in the future (n=34).

6. A health department’s job is to protect the health of the community from health issues that are preventable. WHAT PUBLIC HEALTH DEPARTMENTS DO Monitor health status of populations Investigate, diagnose and address health issues Promote equitable access to healthcare Advocate for health in policies and laws Communicate and educate on health Engage communities and partners to promote health Use laws and regulations to improve health Build a diverse public health workforce Conduct research and evaluations to protect health Build strong organization that protects health Adapted from https://www.cdc.gov/publichealthgateway/publichealthservices/essentialhealthservices.html

7. WHAT PUBLIC HEALTH DEPARTMENTS DO Monitor health status of populations Investigate, diagnose and address health issues Promote equitable access to healthcare Advocate for health in policies and laws Communicate and educate on health Engage communities and partners to promote health Use laws and regulations to improve health Build a diverse public health workforce Conduct research and evaluations to protect health Build strong organization that protects health See detailed suggestions at https://tinapurnat.com/health-x-fact-checking/ WHERE FACTCHECKING ORGANIZATIONS CAN PARTNER

8. Family Society https://www.nytimes.com/2020/01/09/health/teen-vaping-death.html Health System https://www.wake.gov/news/wake-commissioners-ban-new-smoke-or-vape-shops-near-schools-county https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30565-X/fulltext Individual Community Consequences of vaping beyond the individual’s health https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30565-X/fulltext https://www.wake.gov/news/wake-commissioners-ban-new-smoke-or-vape-shops-near-schools-county https://www.theguardian.com/society/2022/aug/07/when-i-see-kids-vaping-i-warn-them-thats-what-killed-my-daughter https://www.army.mil/article/226973/army_issues_public_health_alert_after_multiple_severe_lung_illness_cases_associated_with_vaping https://wsbt.com/news/local/access-and-misinformation-fuel-vaping-as-safe-alternative-to-cigarettes Government https://www.nola.com/news/business/new-vaping-laws-target-flavors-and-vape-types-in-louisiana/article_752a9bd6-6859-11ee-a6ff-5bc71f5dab6b.html

9. Health departments and fact-checkers naturally play different roles in the information environment concerning health. Questions Concerns Information voids Misinformation Disinformation More common, easier to address by health departments PREVENTIVE action Less common, harder to address by health departments ; fact-checking organizations are better placed to address these REACTIVE action See: Managing Infodemics in the 21st Century: https://link.springer.com/book/10.1007/978-3-031-27789-4

10. Six steps of building a business case to work and fundraise for fact-checking in health (1/2) Foster relationships with the health sector Understand current public health needs and priorities and potential avenues of funding Identify and grow your area of comparative advantage Ministry of Health, Institute of Public Health/CDC, medical associations, health-focused civil society organizations, health focused alliances, and academic groups focused on public health. The most critical piece is defining the public health question you can help answer, and researching which organizations could fund the work to do so. (e.g. “How do we address reproductive health misinformation on Tiktok targeting adolescent boys and young men in Tagalog?”) For example, do you have staff with specific expertise in health topic, experience with a target audience (e.g. immigrant communities), or has existing partnerships you can leverage? What new partnerships or skills or resources would you need to gain an advantage? Conducting a SWOT analysis with your team and inviting health experts to join may be a helpful exercise. See detailed suggestions at https://tinapurnat.com/health-x-fact-checking/

11. Six steps of building a business case to work and fundraise for fact-checking in health (2/2) Develop ideas to build capacity or provide expertise to health sector Beta test your concept with public health people Be prepared to educate your audience, and frame ways of collaboration that makes sense for your organization You can offer a services such as factchecking or developing infodemic insights, or conduct research or evaluation, or training, such as training health promotions staff, or serve as a strategic partner to develop plans, foster networks. Develop a business case that includes the above, and describe ways of working, values, and what you would need from the health organization to successfully partner with them. Public health people speak a different language and have different objectives and indicators of success compared to a fact checker. It’s important to test out your pitch on a small group of public health people on the chosen topic. Be also prepared to learn about public health and way its bureaucracy works (often slow, many people involved, lots of procedure and reporting), but successful collaboration can results in big public health rewards See detailed suggestions at https://tinapurnat.com/health-x-fact-checking/

12. Public health challenges to look out for and opportunities for factcheckers (1/4) Health mis/disinformation is seen as a greater threat to public health. However, this is sometimes confused with reputation management or the demand for magic dashboards that track misinformation but are utterly useless for public health action. This is a prime opportunity to present a case for funding your organization or including it as a partner if you write it with a public health frame. Remember you might need to educate your audience and partners. More health workers are reporting increased threats or harassment, attacks, profile spoofing, and doxing in many countries around the world. This is driving more efforts to protect health workers from these new online harms, and equipping them to address misinformation with their patients. The same toolbox journalists and factcheckers use to protect themselves from online harassment and attacks can be adapted for health workers and their employers. Additionally, health workers need training on how to address misinformation online and offline and with their patients. You can provide that training.

13. Climate change and how it affects health is getting increasing public attention and funding. Misinformation on health and climate (animal - human - planetary) continues to grow, including among agriculture workers, peopel who work outside, and other vulnerable communities. Health sector is not always the best at bridging with other sectors. You can b uild partnerships with agencies focused on conservation, environment, and climate as it relates to human health. This comes with new funding sources outside of health. We live in the age of polycrisis, which almost always has a health component, whether it’s wildfires, civil war, mass displacement, elections, mass events gone wrong. Health misinformation, deceptive marketing and alternative cure profiteering will inevitably follow. Having health expertise and existing partnerships to address health dimensions of these emerging issues, makes you more attractive to fundign from health and other domains of society. Public health challenges to look out for and opportunities for factcheckers (2/4)

14. Health departments often have digital footprints from the year 2005. This really undercuts the need to improve the credibility and quality of health information available to successful address information gaps and misinformation. Offer to audit the health information and processes of a health department including website and social media presences, and make recommendations for improvement, including SEO, accessibility, usability, metadata, how to public mythbusters page useful for factcheckers and journalists, and publish and disseminate prebunking content across website and social media networks. Health departments are worried about politicization of health and hijacking in disinformation influence campaigns. Offer to help investigate and respond to health disinformation and reputational attacks. Public health challenges to look out for and opportunities for factcheckers (3/4)

15. There is a push to improve how to understand information environment related to health in public health social listening or infodemic insights report, which is generated by a team in a health department/organization. They need data sources. Your data can input into this process, and can be formatted to be shared and used in integrated analysis for health. A part of public health is focused on building community resilience and engaging communities to promote behavior change in health and build trust with the health system. You can combine factchecking with community-based resilience programs and focus on teaching digital literacy and misinformation identification skills to different audiences. This approach can also be used for health workers when engaging through health system. Public health challenges to look out for and opportunities for factcheckers (4/4)

16. Main challenges and potential solutions in developing factchecking in health sector space Navigating partnerships Access to expertise and information Connecting with other health fact checkers and need for network Maintaining editorial independence Managing conflicts of interest (e.g. with pharma) Defining and measuring public health success How to communicate effectively with health sector How can universities support health factchecking Access to scientific journals, public health information Access to “on call” public health experts How to increase success of asking for comment from experts Funding/ sustainability Where are sources of funding Specific issues in addressing health mis/disinformation How to monitor information environment better and in different languages - do we need to monitor everything to detect health misinformation? How to address health disinformation (e.g. hijacked narratives for political or protifeering ends) Simplify overly complex medical information What to do when there is insufficient evidence/consensus How to ensure that factcheck remains valid in changing scientific landscape Level of information public needs when addressing health claim; health literacy What to do about influencers who spread health misinformation How can healthcare providers better communicate with public How can journalists better understand health topics How does one create trusted sources in health See detailed suggestions at https://tinapurnat.com/health-x-fact-checking/

17. Could we continue this conversation after GlobalFact11? We didn’t have time today to address all topics and questions, but please scan this QR code to join an informal WA of likeminded people to continue the conversation and who want to improve fact-checking in health. You can also contact ANNIE/Annie Lab to find your way to the informal group at [email protected] fact-checking x health WA group SCAN TO JOIN

18. tinapurnat.com/health-x-fact-checking/ Notes on building a business case for health fact-checking SCAN TO JOIN fact-checking x health WA group

19. Thank you very much! [email protected] Resources for infodemic managers