JMIR Publications

ABSTRACT

Background:

The rampant spread of misinformation about COVID-19 has been linked to lower uptake of preventive behaviors such as vaccination. Some individuals, however, have been able to resist believing in COVID-19 misinformation. Further, some have acted as information advocates, helping to spread accurate information and combat misinformation about the pandemic.

Objective:

Guided by the positive deviance framework, which describes how some individuals adopt more positive behaviors than their peers (deemed “positive deviants,” this work explored these information advocates’ perspectives, behaviors, and information-related practices.

Methods:

To identify positive deviants for this study, we used outcomes of survey research of a national sample of 1498 adults to find individuals who scored a perfect or near-perfect score on COVID-19 knowledge questions who also self-reported sharing or responding to news information within the past week. Among this subsample, we selected a diverse sample of 25 individuals to participate in a one-time phone-based, semi-structured interview. Interviews were recorded and transcribed, and the team conducted an inductive thematic analysis

Results:

Positive deviants reported trusting in science, data-driven sources, and public health and medical experts and organizations. They had mixed levels of trust in various social media sites to find reliable health information, noting distrust in particular sites such as Facebook and more trust in specific accounts on sites like Twitter and Redditt. They reported relying on multiple sources of information to find facts instead of intuition and emotions. PDs determined the credibility of information by cross-referencing it, identifying information sources and potential bias, clarifying information they were unclear about with healthcare providers, and using fact-checking sites to verify the information. Most participants reported ignoring misinformation. Others, however, responded to it by flagging, reporting, and responding to the misinformation they saw about COVID-19 on social media sites. Some described feeling more comfortable responding to misinformation in person than online. Participants’ responses to misinformation online depended on various factors, including their relationship to the individual posting the misinformation, their level of outrage in response to it, and how dangerous they perceived it could be if others acted on such information.

Conclusions:

This research illustrates how positive deviants assess the credibility of information, how they share it, and how they respond to misinformation. It illustrates both online and offline information practices and describes how the role of interpersonal relationships contributes to their preferences for acting on such information. Implications of our findings could help inform future training in health information literacy, interpersonal information advocacy, and organizational online information advocacy. It is critical to continue working to share reliable health information and debunk misinformation, particularly since this information informs health behaviors.