JMIR Publications

ABSTRACT

Background:

Health misinformation on social media can negatively affect knowledge, attitudes, and behaviors, thereby undermining clinical care and public health efforts. To date, there is limited understanding of the public’s experience with health misinformation on social media.

Objective:

The goal of this analysis was to examine perceptions of the social media information environment and identify associations between health misinformation perceptions and health communication behaviors using nationally representative data.

Methods:

Analyses were conducted using data from the 2022 Health Information National Trends Survey (HINTS 6, N=6,252). Weighted unadjusted proportions described the amount of social media health information respondents believe is false or misleading (“perceived misinformation amount”) and how difficult it is for respondents to discern true from false information on social media (“perceived discernment difficulty”). Weighted, multivariable logistic regressions examined 1) associations of sociodemographic characteristics, health literacy, digital literacy, and numeracy with misinformation perceptions, and 2) relationships between misinformation perceptions and health communication behaviors (i.e., sharing personal or general health information on social media and using social media information for making health decisions and in discussions with healthcare providers).

Results:

Over one-third of social media users (35.61%) perceived high levels of health misinformation, and two-thirds (66.56%) reported high perceived discernment difficulty. Compared to non-Hispanic White individuals, non-Hispanic Black/African American (aOR: 0.407, 95% CI: 0.282-0.587) and Hispanic (aOR: 0.610, 95% CI: 0.449-0.831) individuals were less likely to report high perceived misinformation amount. Additionally, those with lower subjective health literacy were less likely to report high perceived misinformation amount (aOR: 0.602, 95% CI: 0.374-0.970), while those with lower subjective digital literacy were more likely to report high perceived misinformation amount (aOR: 1.775, 95% CI: 1.400-2.251). Compared to non-Hispanic White individuals, Hispanic individuals were less likely to report high discernment difficulty (aOR: 0.620, 95% CI: 0.462-0.831); perceived discernment difficulty also differed by age. Those with lower subjective digital literacy (aOR: 1.873, 95% CI: 1.478-2.374) or lower subjective numeracy (aOR: 1.465, 95% CI: 1.047-2.049) were more likely to report high discernment difficulty. High perceived misinformation amount was associated with lower odds of sharing general health information on social media (aOR=0.742, 95% CI: 0.568-0.968), using social media information to make health decisions (aOR=0.273, 95% CI: 0.156-0.479), and using social media information in provider discussions (aOR=0.460, 95% CI: 0.323-0.655). High perceived discernment difficulty was associated with greater odds of using social media information in health decisions (aOR=1.724, 95% CI: 1.208-2.460) and provider discussions (aOR=1.389, 95% CI:1.035-1.864).

Conclusions:

Perceptions of high health misinformation prevalence and discernment difficulty are widespread among social media users, and each has unique patterns of association with sociodemographic characteristics, literacy, and health communication behaviors. A better understanding of misinformation perceptions could help inform health communication interventions in both online and offline contexts.