COVID19 Infodemic – A Tsunami of Health Literacy Issues

In this week’s blog, Dr Evelyn McElhinney (@evmcelhinney), Senior Lecturer in Advanced Practice at Glasgow Caldedonian University and the Chair Elect of Health Literacy UK (@literacyhealth) discusses the impact of the current pandemic on health literacy needs and how we as nurses can help.

In February 2020 at the Munich Security Conference Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO) discussed the term Infodemic in the relation to the COVID-19 pandemic stating:

“…we’re not just fighting an epidemic; we’re fighting an infodemic. Fake news spreads faster and more easily than this virus, and is just as dangerous” (https://www.who.int/dg/speeches/detail/munich-security-conference).

In the context of COVID-19 this infodemic has caused a huge amount of information some of which is provided by official governmental public health information sites. However, often misinformation based on rumour, conspiracy theory or misunderstanding of official advice or research has been shared particularly via social media. Given that this is a public health event this has a huge impact on people’s health literacy. Health literacy is the ability to access, appraise, understand, and use information and social resources to make health decisions to maintain or change health behaviour (Nutbeam, 1998; Sørensen et al, 2012). Health literacy is seen as a modifiable social determinant of health which can be improved via interventions. The current infodemic causes a tsunami of health literacy issues through confusion of messages or design of information even from official sites. Within the UK often the official governmental information via the devolved nations is designed differently, has a slightly different message and has to change rapidly in relation to the stage of the pandemic. This adds to what can be perceived by the public as conflicting advice even from official sources, creating a ‘fournationsinfodemic’. The UK Government and devolved nations have tried to mitigate misinformation through daily briefings, updated information and social media and media campaigns. At a global level  the World Health Organisation has produced several reports https://iris.paho.org/bitstream/handle/10665.2/52052/Factsheet-infodemic_eng.pdf?sequence=14 and even held an online world conference  https://www.who.int/news-room/events/detail/2020/06/30/default-calendar/1st-who-infodemiology-conference  Social media companies have committed to attempt to block or remove misinformation. However, this is not always possible as social media posts can be spread rapidly before being taken down or debunked https://www.bbc.co.uk/news/technology-52903680 .

So what can we do as healthcare practitioners, researchers, academics?

At a professional and personal level, nurses and other healthcare practitioners should aim to share trustworthy information via local methods and via online spaces/social media. Where even official messages are causing confusion there is an opportunity for healthcare professionals to help people make sense of the message to improve others health literacy or to signpost to trustworthy information. This includes ‘calling out’ misinformation spread via their personal social media platforms and reminding or helping people to seek out or confirm the source of the information before spreading via their networks. An affirmation or recommendation from a trusted friend especially if people are seen as a ‘trusted’ healthcare professional can help slow or speed up the spread of misinformation. Alternatively, affirmation or recommendation of information can be a powerful endorsement. However, it is important to remember that not all will have access to digital devices or online resources, therefore even sharing information via conversations with family, friends and offline social networks is important to enable improvements in health literacy ensuring inequity of access is not increased.

Of course other ways nurses and other healthcare professionals can contribute to promoting health literacy and stemming the infodemic is by undertaking research, publish, or advise healthcare organisations on health literacy principles. This is always important but never more so in this extraordinary time we are living.

References and other sources

Nutbeam, D. (1998) ‘Health promotion glossary’, Health Promotion International, 13, 4, 349-64.

Sørensen, K., Van den Broucke, S., Fullam, J. et al. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health 12, 80 (2012). https://doi.org/10.1186/1471-2458-12-80

From pandemic to infodemic https://ec.europa.eu/commission/presscorner/detail/en/speech_20_1000

World Health Organisation video How to protect yourself in a pandemic https://youtu.be/E5Egi0nuDEs

Tangcharoensathien V, Calleja N, Nguyen T, Purnat T, D’Agostino M, Garcia-Saiso S, Landry M, Rashidian A, Hamilton C, AbdAllah A, Ghiga I, Hill A, Hougendobler D, van Andel J, Nunn M, Brooks I, Sacco PL, De Domenico M, Mai P, Gruzd A, Alaphilippe A, Briand S Framework for Managing the COVID-19 Infodemic: Methods and Results of an Online, Crowdsourced WHO Technical Consultation J Med Internet Res 2020;22(6):e19659 DOI: https://doi.org/10.2196/19659

Slides and video from EHMA Webinar: Health Systems & Health Literacy in the time of COVID-19 https://ehma.org/webinar-health-systems-health-literacy-covid-19/ and video https://youtu.be/ZOiKvx-hyLQ

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