JMIR Publications

ABSTRACT

Background:

Misinformation in healthcare poses a significant threat by undermining public health initiatives, propagating dangerous behaviours, and influencing rational decision-making about health-related behaviours. There is a substantial demand for online interventions targeting this misinformation, given its high-risk capacity on online platforms and social media. Literature underscores the importance of using theoretical underpinnings, frameworks or models to develop effective educational interventions, specifically targeting characteristics of misinformation and human attributes that make audiences susceptible to it.

Objective:

This scoping review examines the literature for online interventions implemented to combat health misinformation. We examine online interventions implemented to address health misinformation to mitigate adverse effects on public health outcomes, including the types of interventions, population demographics, human attributes increasing susceptibility, and characteristics of misinformation targeted by interventions. The theoretical underpinnings used to develop such interventions and gaps in literature are also identified.

Methods:

A search of five databases was conducted for studies published between 2018 and 2024 using keywords and Medical Subject Headings terms related to health misinformation. Studies were moved to reference management software and underwent duplication removal and title and abstract screening against inclusion criteria. Full-text screening and data extraction was then conducted. The review followed the Arksey and O’Malley framework and is reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews guidelines.

Results:

The initial search yielded 418 citations, of which 52 underwent full-text screening and extraction, leading to 30 included papers. Reasons for exclusion included interventions not being implemented in real-world contexts or not being online. 18 studies (60%) addressed COVID-19-related misinformation, 11 studies (36.6%) addressed misinformation in other health contexts, and 1 study (3.3%) targeted the concept of misinformation more holistically. 22 studies (73.3%) employed educational interventions, 7 (23.3%) used counterspeech, and 1 (3.3%) used online inoculation games. 16 interventions (53.3%) reported targeting specific characteristics of misinformation in the development process, and 14 studies (46.7%) reported that their intervention would target human attributes that increase susceptibility to misinformation. Only 7 studies (23.3%) catered their intervention to specific demographic populations who would maximally benefit from it.25 citations (80%) reported using one or more theoretical underpinnings to develop the intervention's content or learning and design component.

Conclusions:

Online interventions addressing healthcare misinformation online often share similar target outcomes. However, they are guided by a diverse range of theoretical underpinnings, as thematically categorized in the review. This diversity is a key aspect of their effectiveness. The review also reveals gaps in the literature, particularly in understanding the characteristics of misinformation, demographics, and human attributes that are systematically targeted by these interventions as key properties which need to be addressed for interventional success.