JMIR Publications

ABSTRACT

Background:

The spread of online health misinformation has been on the rise for years but was greatly accelerated during the COVID-19 pandemic, during which novel conspiracy theories and misleading messages about vaccines emerged and long-standing arguments against vaccines gained momentum in public narratives. Health misinformation was especially prolific on social media, with strategies like content moderation implemented far less extensively for Spanish-language content. While some studies have identified common persuasive tactics used to propagate health misinformation or conspiratorial thinking, few have explored use of these tactics in Spanish-language content on social media for U.S. audiences.

Objective:

This study examined persuasive tactics used to promote COVID-19 and vaccine misinformation and conspiracies in Spanish-language comments on Brigada Digital de Salud’s public Facebook page.

Methods:

Informed by an integration of Elaboration Likelihood Model and theories in motivated reasoning, confirmation bias and selective exposure, and social identity, a qualitative content analysis was conducted on a data set of 902 comments in response to 13 posts on the Brigada Digital de Salud Facebook page that were published between June 15, 2022 to January 1, 2023. Persuasive tactics were conceptualized as being either low elaboration tactics, reliant on heuristics and superficial cues to seed beliefs (peripheral route exposure), or high elaboration tactics that sought to entrench misinformation and conspiracy beliefs (central route reinforcement). Comments applying these tactics were then analyzed to identify thematic commonalities.

Results:

Results demonstrated that six low elaboration persuasive tactics in three overarching categories were used to propagate COVID-19 and vaccine misinformation and conspiracies, including making value-based appeals and amplifying uncertainty (emotional arousal), making identity-based appeals and social norm creation (in-group identity framing), and questioning transparency of health officials or pharmaceutical companies or trustworthiness of healthcare providers (distrust priming). Results also showed that five high elaboration persuasive tactics in four overarching categories were used, including using arguments that vaccines were ineffective and unnecessary (pseudo-evidence), reinforcing distrust with conspiratorial arguments (entrenchment of distrust), questioning the accountability of healthcare providers and also leveraging the authority of healthcare professionals to promote vaccine misinformation (authority reversal), and dismissing official data (counterarguing).

Conclusions:

Recent policy shifts have scaled back content moderation on social media platforms and there is growing divisiveness of public health discourse in the U.S. These findings increase our understanding of persuasive tactics commonly used among Spanish-speaking audiences to promote health misinformation and conspiratorial thinking on digital platforms. Future strategies should use trusted, in-group messengers and pair trust-building peripheral cues with gradually introduced central route, identity-affirming framed messaging to reduce resistance to the accurate health information. Strategies should also seek to improve communities’ digital health literacy to mitigate misinformation vulnerability and support informed health decision-making. Clinical Trial: n/a