Tackling Rumors and Understanding & Strengthening Trust (TRUST) in Public Health

Addressing misinformation based on rumor type

Rumors tend to fall into 3 overarching and overlapping categories: culture, communication, and cognition (“the 3 Cs”). There is no one approach that will successfully reduce all rumor types, so a combination of efforts is typically needed.

The 3 Cs, culture, communication, and cognition


Below is a list of actions that can be used to address culture-, communication-, and cognition-related misinformation. Actions at the top of each list need fewer resources, while actions at the bottom of the list need more resources. Each situation likely will require different action(s). 

Note: Some types of rumors have appeared often during past public health emergencies and could come up again in future events. Learn more about these types of rumor here. 

Culture-related misinformation

Culture-related misinformation includes rumors based on social, political, and cultural beliefs and practices, like sociocultural narratives. This could look like beliefs about vaccines being harmful, the government not being trustworthy, some political parties or groups being better or worse than others, and more. This category of rumors can sometimes recycle existing narratives around racism, sexism, etc. and link them to new public health issues.

Actions to address culture-related misinformation:

  • Moral reframing: use techniques to frame messages in a way that aligns with audience values and beliefs.
  • Debunking: refute or correct false claims, especially by explaining the misleading techniques, flawed reasoning, or logical fallacies (ie, logic-based debunking) or by drawing attention to its unreliable source (ie, source-based debunking).
  • Partner with trusted, matched messengers: share anti-misinformation messages through messengers who represent the audience’s demographics, worldviews, values, and beliefs, and who intended audiences trust and/or listen to.
  • Engage communities: unite people behind a shared purpose and solve problems together.
  • Build trust: focus on repairing relationships and building trust with communities both before and during public health events. 
  • Shift social norms: change the unspoken rules that guide people’s behavior and empower people to change how they think/behave.

Tips for improving the effectiveness of actions and avoiding negative consequences:

DODON’T
  • Use an in-group spokesperson to better connect with your intended audience.1,2
  • Customize content for specific target audiences.
  • Use messages that strongly appeal to morals and emotions like compassion, but not panic.1,3 
  • Consider using different types of debunking: fact-based, logic-based, and source-based debunking techniques have been successful for general audiences, though are not guaranteed to work.4 
  • Affirm audience identity before providing corrections that could threaten their views.5
  • Be empathetic. People may feel confusion or fear during uncertain times.4 
  • Don’t alienate your audience. Do not prioritize fact-checking rumors if it means attacking deeply held beliefs.6
  • Don’t use scare tactics to change people’s beliefs.7 
  • Don’t try to debunk conspiracy theories if the audience consists of true believers, as this could do more harm than good.4,8
  • Don’t overburden resource-limited community organizations with more unpaid work.
  • Don’t reinforce harmful social norms. 
  • Don’t ignore behavioral and social evidence when designing messages, especially for vaccine hesitant groups who care about efficacy, safety, and disproportionate risks to vulnerable communities.9
  • Don’t worry that reframing messages may negatively impact people outside your target audience. Evidence suggests this is unlikely.1
Communication-related misinformation

Communication-related misinformation includes rumors that spread because of issues with how accurately and effectively information is shared with people. This could be because of poorly framed messages, constantly changing messages, or misrepresenting issues by misleading, downplaying, inflating, and cherry-picking information, either accidentally or intentionally (often done by bad actors who want to take advantage of the public’s negative emotional reaction).

Actions to address communication-related misinformation:

  • Risk communication: train public health communicators to use good practices when addressing health risks and misinformation. 
  • Fill information voids: quickly provide easy-to-understand, credible, accessible, and correct information to people.
  • Amplify accurate information: share accessible, audience-specific, and culturally appropriate information from first-hand or other trusted sources or point people to those trusted sources.
  • Debunking: refute and fact-check false information by pointing out why a claim is false and sharing alternative explanations. 
  • Improve health, science, and media literacy: teach people to think critically about information, especially how to look for credible information and understand the scientific process.

Tips for improving the effectiveness of actions and avoiding negative consequences:

DODON’T
  • Act quickly before other actors can fill the void with misinformation.
  • Collaborate with communities to develop culturally appropriate messaging. 
  • Offer factual alternative explanations when correcting false information.10
  • Strike a balance between acknowledging uncertainty and providing the public with concrete facts.
  • Warn readers that you’re going to repeat false claims in order to debunk the rumor.10
  • Repeat the guidance you want people to follow. Repetition can increase retention.11
  • Make sure that all key communicators/spokespeople share consistent messaging strategies. 
  • Encourage the original sources to provide rumor corrections.12
  • Make debunking messages “sticky”—keep language simple, use familiar phrases, and repeat debunked messages.13,14
  • Use simple language and graphics.5,15
  • Plan ahead. Have a strategy in place to respond if bad actors seize messages and use them to further their own agendas.
  • Don’t repeat false information more than once in a correction. Repetition can increase belief in false information.12
  • Don’t wait to debunk a rumor; as time passes from when someone hears the original rumor, it gets more difficult to change their beliefs.6
  • Don’t ignore possible problems, like people twisting your messages or taking them out of context, or public officials or influencers discrediting you to further their own agendas.
  • Don’t discount the role experts can play in correcting misinformation. In some cases, corrections can be more effective when communicated by an expert compared to a non-expert.16
  • Don’t refuse to acknowledge when the public received incorrect guidance from official or reputable sources.
  • Don’t ignore potential consequences from being too slow/fast to correct misinformation, rushing to fill information gaps even though scientific evidence is still evolving, and looking like you’re out of the loop.
Cognition-related misinformation

Cognition-related misinformation refers to rumors that result from how people think, process new information, and use mental shortcuts to make sense of things they see, hear, or experience. This might occur when people process and interpret information during a crisis. People may jump to conclusions when trying to clarify uncertainty and reduce uncertain risk; stay silent because they believe that most people hold a different opinion from their own (pluralistic ignorance); think that other people are more easily influenced than them (third person effect); interpret information in a way that confirms what they already believe (confirmation bias); and feel apathetic or overconfident when experiencing an escalating public health crisis.

Actions to address cognition-related misinformation:

  • Fill information voids in a simple way: present people with information that requires them to carry out only simple mental tasks to process the information.
  • Acknowledge uncertainty: in situations where evidence is evolving, provide information about what you know, what you don’t know, and talk about what the scientific community is trying to learn. 
  • Provide alternative explanations: “unstick” rumors from people’s minds by showing them alternatives to false claims and encouraging them to think critically about information.
  • Reuse people’s cognitive processes: use common cognitive processes and heuristics, or the mental shortcuts people use to understand the world, when creating debunking messages.
  • Improve science literacy: teach people to understand how and why public health guidance evolves during health events and teach them to watch for logical fallacies that may mislead them.

Tips for improving the effectiveness of actions and avoiding negative consequences:

DODON’T
  • Improve audiences’ ability to judge the credibility of sources sharing information related to a rumor, such as by assessing the reputation of a source, whether the author is qualified to discuss the issue, how accurate the information is, etc.17
  • Make sure messaging comes from a source with perceived credibility and expertise.18,19
  • Prepare audiences for the possibility that guidance and messages may change.20
  • Strike a balance between acknowledging uncertainty and providing the public with concrete facts.
  • Be prepared for rumors to persist—even after debunking.21
  • Empower audiences to amplify factual information in their circles.22
  • Prioritize appealing to people’s existing beliefs over fact-checking them or pointing out that the source of a rumor is not credible.6 
  • Don’t simply replace old information with new information without explaining why the old information is no longer accurate.20
  • Don’t over-reassure people during uncertain situations. You may lose credibility when/if your guidance needs to change. 
  • Don’t assume that telling people about their individual risk of disease will influence their actions.23 Overemphasizing individual risk may actually increase a person’s unrealistic optimism in not getting or transmitting a disease, particularly as a coping mechanism.24
  • Don’t refuse to acknowledge when the public received incorrect guidance from official or reputable sources.
  • Don’t repeat false information unnecessarily.5,10

Please note: The information provided in this section is designed to provide an overview of existing tools and approaches to manage misinformation and enhance communication in an environment of mistrust. Determining which tools and approaches are best for specific situations requires a customized approach, as highlighted in the Practical playbook for addressing health misinformation.

References
  1. Feinberg M, Willer R. Moral reframing: A technique for effective and persuasive communication across political divides. Soc Pers Psychol Compass. 2019;13(12):e12501. doi:10.1111/spc3.12501
  2. Wolsko C, Ariceaga H, Seiden J. Red, white, and blue enough to be green: Effects of moral framing on climate change attitudes and conservation behaviors. J Exp Soc Psychol. 2016;65:7-19. doi:10.1016/j.jesp.2016.02.005
  3. Feinberg M, Willer R. The Moral Roots of Environmental Attitudes. Psychol Sci. 2013;24(1):56-62. doi:10.1177/0956797612449177
  4. Lewandowsky S, Cook J. The Conspiracy Theory Handbook. DigitalCommons@University of Nebraska - Lincoln; 2020. https://digitalcommons.unl.edu/scholcom/246
  5. Ecker UKH, Lewandowsky S, Cook J, et al. The psychological drivers of misinformation belief and its resistance to correction. Nat Rev Psychol. 2022;1(1):13-29. doi:10.1038/s44159-021-00006-y
  6. Walter N, Murphy ST. How to unring the bell: A meta-analytic approach to correction of misinformation. Commun Monog. 2018;85(3):423-441. doi:10.1080/03637751.2018.1467564
  7. Whitehead HS, French CE, Caldwell DM, Letley L, Mounier-Jack S. A systematic review of communication interventions for countering vaccine misinformation. Vaccine. 2023;41(5):1018-1034. doi:10.1016/j.vaccine.2022.12.059
  8. Zembylas M. Moving beyond debunking conspiracy theories from a narrow epistemic lens: ethical and political implications for education. Pedago Cult Soc. 2023;31(4):741-756. doi:10.1080/14681366.2021.1948911
  9. UNICEF Middle East and North Africa, Public Goods Project, First Draft, Yale Institute for Global Health. Vaccine Misinformation Management Field Guide. UNICEF; 2020. Accessed October 18, 2023. https://www.unicef.org/mena/reports/vaccine-misinformation-management-field-guide
  10. Lewandowsky S, Ecker UKH, Seifert CM, Schwarz N, Cook J. Misinformation and Its Correction: Continued Influence and Successful Debiasing. Psychol Sci Public Interest. 2012;13(3):106-131. doi:10.1177/1529100612451018
  11. Sutton J, Fischer L, Wood MM. Tornado Warning Guidance and Graphics: Implications of the Inclusion of Protective Action Information on Perceptions and Efficacy. Weather Clim Soc. 2021;13(4):1003-1014. doi:10.1175/WCAS-D-21-0097.1
  12. Walter N, Tukachinsky R. A Meta-Analytic Examination of the Continued Influence of Misinformation in the Face of Correction: How Powerful Is It, Why Does It Happen, and How to Stop It? Commun Res. 2019;47(2). doi:doi.org/10.1177/0093650219854600
  13. Shane T. The psychology of misinformation: Why we’re vulnerable. First Draft. Published June 30, 2020. Accessed October 18, 2023. https://firstdraftnews.org/articles/the-psychology-of-misinformation-why-were-vulnerable/
  14. Pennycook G. A Perspective on the Theoretical Foundation of Dual Process Models. In: De Neys W, Ed. Dual Process Theory 2.0. Routledge; 2018.
  15. Nisbet EC, Kamenchuk O. The Psychology of State-Sponsored Disinformation Campaigns and Implications for Public Diplomacy. Hague J Dipl. 2019;14(1-2):65-82. doi:10.1163/1871191X-11411019
  16. Walter N, Brooks JJ, Saucier CJ, Suresh S. Evaluating the Impact of Attempts to Correct Health Misinformation on Social Media: A Meta-Analysis. Health Commun. 2021;36(13):1776-1784. doi:10.1080/10410236.2020.1794553
  17. Metzger MJ, Flanagin AJ. Credibility and trust of information in online environments: The use of cognitive heuristics. J Pragmat. 2013;59:210-220. doi:10.1016/j.pragma.2013.07.012
  18. Higgins G, Freedman J. Improving decision making in crisis. J Bus Contin Emerg Plan. 2013;7(1):65-76.
  19. Cummings L. The “Trust” Heuristic: Arguments from Authority in Public Health. Health Commun. 2014;29(10):1043-1056. doi:10.1080/10410236.2013.831685
  20. Hodson J, Reid D, Veletsianos G, Houlden S, Thompson C. Heuristic responses to pandemic uncertainty: Practicable communication strategies of “reasoned transparency” to aid public reception of changing science. Public Underst Sci. 2023;32(4):428-441. doi:10.1177/09636625221135425
  21. Chan MS, Jones CR, Jamieson KH, Albarracín D. Debunking: A Meta-Analysis of the Psychological Efficacy of Messages Countering Misinformation. Psychol Sci. 2017;28(11):1531-1546. doi:10.1177/0956797617714579
  22. Rogers LS, Moran N. Consultation with Nick Moran, Director of Audience Engagement, and Lindsay Smith Rogers, MA, Director of Content Strategy at Communications and Marketing at Johns Hopkins Bloomberg School of Public Health. Published online October 26, 2023.
  23. Felgendreff L, Korn L, Sprengholz P, Eitze S, Siegers R, Betsch C. Risk information alone is not sufficient to reduce optimistic bias. Res Soc Adm Pharm. 2021;17(5):1026-1027. doi:10.1016/j.sapharm.2021.01.010
  24. McColl K, Debin M, Souty C, et al. Are People Optimistically Biased about the Risk of COVID-19 Infection? Lessons from the First Wave of the Pandemic in Europe. Int J Env Res Public Health. 2022;19(1):436. doi:10.3390/ijerph19010436

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