During the COVID-19 pandemic, misinformation proliferated across social and traditional media, often with serious public health consequences (Caceres et al., 2022). Moreover, it was found the belief in COVID-19 misinformation resulted in fewer COVID-19 preventive behaviours (Lee et al., 2020). Despite being demonstrably false, claims such as ‘5G spreads the virus’, or ‘bleach can cure COVID-19’ gained traction among some people. In contrast, scientifically grounded behaviour change messages, such as those promoting handwashing or physical distancing, sometimes failed to achieve adherence (den Daas et al., 2024; Dixon et al., 2021; Lee et al., 2020).
Without previous knowledge on a topic or fact checking, information and misinformation might be indistinguishable. Several factors have been identified to contribute to belief in misinformation related to the message (and its source) including consistency with already held beliefs (Bryanov & Vziatysheva, 2021). When it comes to why someone might spread misinformation, it can happen unintentionally, someone misunderstanding information or believing the misinformation themselves, but some sources may have ideological motives or financial interests. Claims that honey prevents or cures COVID-19 were made by honey sellers. Although, eating honey might be good for you, and might even have anti-inflammatory, antimicrobial, and antioxidant properties (Samarghandian et al., 2017), it is unlikely to protect you from contracting COVID-19.
One of the factors influencing whether information is believed is the perceived credibility of its source. People are more likely to accept information from sources they trust, such as political leaders, social media influencers, or individuals within their social networks, regardless of whether the information is correct (Sanna & Lagnado). Taking one of the above examples, the claim that injecting disinfectants could cure COVID-19 gained visibility after it was suggested by U.S. President Donald Trump during a press briefing. Although the claim was immediately refuted by scientists, the idea did enter public discourse. This increased interest has not, yet, had evidence of a change in actual behaviour with a person ingesting or injecting bleach (though it’s hard to say what happens in the privacy of a believer’s home), but from believing the misinformation to behaviour could be a small step.
A key strength of misinformation lies in its simplicity and emotional appeal. Misinformation can be crafted without the constraints of scientific accuracy, enabling people to tailor messages that are emotionally salient, personally relevant, and easy to understand. For instance, ‘5G networks spread the virus’ is a short, emotionally resonant statement that can appeal to individuals experiencing fear. It offers a straightforward albeit false explanation that may be easier to grasp than complex epidemiological models. This message did have behavioural consequences, it led to the destruction of mobile phone masts (Jolley & Paterson, 2020).
Evidence-based behaviour change messages, by contrast, are often complex and qualified. Consider the following examples:
- ‘Washing your hands prevents COVID-19.’
- ‘Washing your hands prevents COVID-19, if you wash them thoroughly, for 2 minutes, with soap, and at the right times for example when you get home or before eating.’
The first is simpler and more likely to be remembered, but less precise and therefore potentially ineffective in preventing COVID-19. The second is more accurate, but potentially difficult to understand or too long and thus ignored.
Another distinction is the nature of the behaviours messages seek to promote. Misinformation (and marketing approaches) often target behaviours that are desirable but not necessary (such as purchasing unnecessary products or believing comforting misinformation). These behaviours typically align with existing preferences or biases and often offer immediate gratification. In contrast, behaviour change interventions frequently target behaviours that are beneficial but may be inconvenient, effortful, or unpleasant (such as isolating when symptomatic, wearing masks, or maintaining physical distance). These behaviours offer long-term benefits, but few immediate rewards.
Before designing interventions, behavioural scientists define the health issue in behavioural terms. For instance, rather than focusing abstractly on COVID-19, specific behaviours are identified (Hubbard et al., 2023). These behaviours must be specified in sufficient detail, a principle that explains the difference between the two handwashing statements above. Behaviour change is approached through frameworks specifying determinants of these behaviour, which can be changed. For example, the COM-B framework incorporates Capability, Opportunity, and Motivation as determinants of behaviour (Michie et al., 2014).
Interventions aim to influence the determinants of behaviour using Behaviour Change Techniques (BCTs), the “active ingredients” of interventions (Michie et al., 2013). Information plays a central role in some BCTs. For example, one BCT aiming to change behaviour by increasing Motivation is ‘Information about health consequences’. Specifically, you provide information (e.g., written, verbal, or visual) about health consequences of performing the behaviour (see the handwashing quotes). Similarly, you could give information about emotional, social and environmental consequences.
Notably, behaviour change frameworks do not inherently differentiate between accurate information and misinformation. Both can operate through the same psychological mechanisms. However, we have already seen that these messages differ in simplicity and types of behaviour targeted. This partly explains why misinformation can be so effective, despite lacking a factual basis.
Because it is not limited by truth or evidence, misinformation benefits by being more flexible and adaptable. Thus misinformation can be adjusted for relevance, matching peoples’ beliefs, and include direct instructions and so could be more persuasive and easier to follow (Eldredge et al., 2016, page 376 and 381). When not limited by the nuance of real-life, or being truthful, those promoting either information or misinformation can easily adjust messages to be more relevant, more consistent with personal beliefs, more emotional, more salient, in short more convincing. People tend to seek out information that aligns with their existing views, participating in ‘information bubbles’ or ‘echo chambers’. Behaviour change interventions that contradict these views, including messages encouraging vaccination or mask-wearing, must overcome significant psychological resistance.
A final challenge is that even accurate information can become misinformation if it is incomplete or misinterpreted. The first handwashing quote may be technically true in general terms but could lead to ineffective behaviour. If individuals wash for less than 20 seconds, skip key parts of their hands, or fail to wash at critical moments, the protective effect diminishes, but confidence in protection may be falsely enhanced. In this context, imprecise messages may not only be ineffective, messages may unintentionally promote risk. This underscores the ethical responsibility of scientists, healthcare professionals, and policymakers to ensure that even simplified messages do not compromise accuracy. Future research is need to explore how misinformation, its level of acceptance and belief, affects behaviour and ultimately health.
References
- Bryanov, K., & Vziatysheva, V. (2021). Determinants of individuals’ belief in fake news: A scoping review determinants of belief in fake news. PLoS one, 16(6), e0253717.
- Caceres, M. M. F., Sosa, J. P., Lawrence, J. A., Sestacovschi, C., Tidd-Johnson, A., Rasool, M. H. U., Gadamidi, V. K., Ozair, S., Pandav, K., & Cuevas-Lou, C. (2022). The impact of misinformation on the COVID-19 pandemic. AIMS Public Health, 9(2), 262.
- den Daas, C., Johnston, M., Hubbard, G., & Dixon, D. (2024). Looking back at Covid-19 government restrictions: were local lockdown regions with tighter restrictions less adherent before the restrictions and more adherent after? Translational behavioral medicine, 14(12), 732-737.
- Dixon, D., Den Daas, C., Hubbard, G., & Johnston, M. (2021). Using behavioural theory to understand adherence to behaviours that reduce transmission of COVID‐19; evidence from the CHARIS representative national study. British journal of health psychology.
- Eldredge, L. K. B., Markham, C. M., Ruiter, R. A., Fernández, M. E., Kok, G., & Parcel, G. S. (2016). Planning health promotion programs: an intervention mapping approach. John Wiley & Sons.
- Hubbard, G., Daas, C. d., Johnston, M., Dunsmore, J., Maier, M., Polson, R., & Dixon, D. (2023). Behavioural Sciences Contribution to Suppressing Transmission of Covid-19 in the UK: A Systematic Literature Review. International journal of behavioral medicine, 1-18.
- Jolley, D., & Paterson, J. L. (2020). Pylons ablaze: Examining the role of 5G COVID‐19 conspiracy beliefs and support for violence. British journal of social psychology, 59(3), 628-640.
- Lee, J. J., Kang, K.-A., Wang, M. P., Zhao, S. Z., Wong, J. Y. H., O’Connor, S., Yang, S. C., & Shin, S. (2020). Associations between COVID-19 misinformation exposure and belief with COVID-19 knowledge and preventive behaviors: cross-sectional online study. Journal of medical Internet research, 22(11), e22205.
- Michie, S., Atkins, L., & West, R. (2014). The behaviour change wheel: A guide to designing interventions (1st ed. ed.). Silverback Publishing.
- Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., Eccles, M. P., Cane, J., & Wood, C. E. (2013). The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Annals of Behavioral Medicine, 46(1), 81-95.
- Samarghandian, S., Farkhondeh, T., & Samini, F. (2017). Honey and health: A review of recent clinical research. Pharmacognosy research, 9(2), 121.
- Sanna, G. A., & Lagnado, D. Rational Belief Updating in the Face of Misinformation: The Role of Source Reliability. Available at SSRN 4907730.
