Throughout the world, including the United States, medical professionals and patients are facing both a pandemic and an infodemic — the first caused by SARS-CoV-2 and the second by misinformation and disinformation. The Annenberg Public Policy Center’s tracking of social and legacy media has found that millions of people have been exposed to deceptive material alleging that SARS-CoV-2 is a hoax or that experts are exaggerating its severity and the extent of its spread, that masks are ineffective or increase infection risk, or that Covid-19 vaccines cause the disease, alter the recipient’s DNA, or include tracking devices. Believing such claims is associated with a lower likelihood of engaging in preventive behavior and a lower willingness to be vaccinated.¹

Point-of-care ultrasound (POCUS) is an imaging modality used to make expedient patient care decisions at bedside. Though its diagnostic utility has been extensively described, POCUS is not yet considered standard of care in inpatient settings. Data from emergency department settings suggest that POCUS may yield socioemotional benefits beyond its diagnostic utility; furthermore, elements of the POCUS experience are known to promote placebo effects. These elements likely contribute to a placebo-like “POCUS positive care effect” (PPCE) with socioemotional benefits for receptive patients. Our objective is to provide the first characterization of the PPCE and its facilitating factors in an inpatient setting. In this novel mixed-methods study, we recruited 30 adult patients admitted to internal medicine floors in an urban academic medical center, recorded observations during their routine POCUS encounters, and administered post-encounter surveys. We conducted complementary quantitative and qualitative analyses to define and assess the magnitude of the PPCE. We also aimed to identify factors associated with and facilitating receptiveness to the PPCE. The results indicated that POCUS improves patients’ satisfaction with their hospital providers and care overall, as well as perceived care efficiency. Mutual engagement, strong therapeutic alliances, and interpreting POCUS images to provide reassurance are most closely associated with this PPCE. Patients who have lower anxiety levels, less severe illness, and received efficient care delivery during their hospitalizations are most receptive to the PPCE. We conclude that diagnostic POCUS has the potential to exert a positive care effect for hospitalized patients. This PPCE is associated with modifiable factors at the patient, provider, and environment levels. Together, our findings lay the groundwork for an optimized “therapeutic POCUS” that yields maximal socioemotional benefits for receptive patients.

Researchers have linked circulating misinformation in online platforms to low COVID-19 vaccine uptake. Two disparate literatures provide relevant initial guidance to address the problem. Motivational Interviewing (MI) effectively reduces vaccine hesitancy in clinical environments; meanwhile, social scientists note inoculation, rebuttal, and appeals to accuracy are persuasive in digital contexts. A tension is inherent in these approaches. MI in digital forums may induce an ‘illusory truth effect,’ wherein falsehoods appear more accurate through repetition. Yet, rebutting misinformation directly may elicit backfire or reactance effects, motivating some to amplify their presentation of misinformation. Building on Identity Process Theory, we propose a theoretical framework for conducting MI-based infodemiology interventions among digital communities that conceptualizes the community in toto (rather than one specific person) as the unit of focus. Case examples from interventions on public Facebook posts illustrate three processes unique to such interventions: 1) Navigating tension between addressing commenters and “bystanders”; 2) Activating pro-vaccine bystanders; and 3) Reframing uncertainty or information individuals might find concerning or threatening according to implied collective values. This paper suggests community-oriented MI can maximize persuasive effects on bystanders while minimizing potential reactance from those with committed beliefs, thereby guiding community-oriented public health messaging interventions enacted in digital environments.

The rapid spread of medical rumors and false or misleading information on social media during times of uncertainty is a vexing challenge that threatens public health. Understanding the information ecosystem, social media networks, and the scope of incentives that drive users and social media platforms can provide critical insights for strong coordination between stakeholders and funders to address this challenge. The COVID-19 pandemic created an opportunity to demonstrate the role of media monitoring and counter-messaging efforts in responding to dangerous medical rumors, misinformation, and disinformation. It also highlighted the challenges. The efforts of ThisIsOurShot and VacunateYa to spread accurate health information about COVID-19 and COVID-19 vaccines are described and lessons learned are discussed. These lessons include the need for substantial financial investments at the local and national levels to sustain and scale these types of programs. Examples in other fields that offer a path forward include Information Sharing and Analysis Centers and Public Health Emergency Operations Centers. Understanding the scale and scope of what it takes to address viral medical rumors, misinformation, and disinformation in a networked information environment should inspire elected leaders to consider policy and regulatory reforms. Our transformed information ecosystem requires new public health infrastructure to address information that threatens personal safety and population health.

Objective We sought to examine reasons for vaccine hesitancy among online communities of US-based Black and Latinx communities to understand the role of historical racism, present-day structural racism, medical mistrust and individual concerns about vaccine safety and efficacy. Design A qualitative study using narrative and interpretive phenomenological analysis of online bulletin board focus groups. Setting Bulletin boards with a focus-group-like setting in an online, private, chat-room-like environment. Participants Self-described vaccine hesitant participants from US-based Black (30) and Latinx (30) communities designed to reflect various axes of diversity within these respective communities in the US context. Results Bulletin board discussions covered a range of topics related to COVID-19 vaccination. COVID-19 vaccine hesitant participants expressed fears about vaccine safety and doubts about vaccine efficacy. Elements of structural racism were cited in both groups as affecting populations but not playing a role in individual vaccine decisions. Historical racism was infrequently cited as a reason for vaccine hesitancy. Individualised fears and doubts about COVID-19 (short-term and long-term) safety and efficacy dominated these bulletin board discussions. Community benefits of vaccination were not commonly raised among participants. Conclusions While this suggests that addressing individually focused fear and doubts are central to overcoming COVID-19 vaccine hesitancy in Black and Latinx groups, addressing the effects of present-day structural racism through a focus on community protection may also be important.

Background: Sexual and reproductive health and rights (SRHR) are foundational to both individual autonomy and global well-being. Misinformation in this domain poses serious risks by undermining evidence-based decision-making, weakening systems of accountability, and perpetuating social injustices. Objective: This scoping review aimed to map and synthesize evidence on the forms, spread, and impacts of misinformation related to SRHR in digital spaces, with a particular focus on implications for the protection and promotion of human rights. Methods: We conducted a scoping review of scientific papers and gray literature. It was guided by the JBI (Joanna Briggs Institute) population, exposure, and outcomes framework. The extracted information was documented following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. Thematic analysis was carried out and mapped against human rights standards: (1) equality and nondiscrimination; (2) Availability, Accessibility, Acceptability, and Quality; (3) informed decision-making; (4) privacy and confidentiality; (5) participation and inclusion; and (6) accountability. Results: Of the 254 eligible studies and documents, 133 focused on the information ecosystem, 37 on the individual, 32 on service delivery and health system, 31 on law and policy, and 21 on community levels. SRHR misinformation impacts individuals’ informed SRHR decisions by shaping their beliefs, attitudes, and health-seeking behaviors. It reinforces harmful and discriminatory social norms at community levels and the exclusion of marginalized voices. SRHR misinformation impacts health systems by shaping provider knowledge and practice, disrupting service delivery, and creating barriers to equitable care. It may function as a legal and policy tool to erode SRHR protections. The design of online platforms, digital marketing strategies, and content moderation policies enables misinformation to spread widely while restricting credible SRHR content. Conclusions: SRHR misinformation in digital spaces is a systemic issue that undermines human rights across multiple levels, highlighting the urgent need for integrated, rights-based approaches to research, policy, and intervention.