Defining Health Misinformation: Theoretical Concept Analysis

Health misinformation is a serious and growing concern, especially in the era of mass digitalization. However, the term lacks conceptual clarity, reducing our ability to build a reliable, replicable evidence base about how misinformation works and undermining our attempts to develop effective responses. There is, therefore, a need to examine how the term is used and to develop a coherent definition that better reflects people's information priorities, concerns, and understandings of the concept.

This study aimed to surface common themes and debates around the concept of "misinformation" in contemporary English-language discourses about health. Specifically, we aimed to examine how people understand the problem of health misinformation (ie, its causes and consequences), how they perceive the relationship between "misinformation" and other problematic information, and any unresolved conceptual tensions.

We conducted a 3-phase hybrid concept analysis following a framework from Schwartz-Barcott and Kim (2000), comprising (1) a theoretical, literature-based phase, (2) a fieldwork/primary interview phase, and (3) an integrative phase combining findings from the first 2 phases. This paper reports methods and findings from the first phase, an inductive, qualitative literature review and analysis. In this phase, we conducted a systematic search of recent literature on health misinformation (published between 2016 and 2022), selected a stratified random sample, and conducted inductive thematic analysis following the methods outlined by Rodgers (2000). A thematic, narrative summary of the findings is presented herein.

Authors identified rapid technological change, information predators, and cultural issues (eg, social fragmentation, growing epistemic disagreement, and the loss of information authorities) as antecedents to health misinformation. They characterized health misinformation as a scourge, identifiable by its falseness or deceptiveness, the use of persuasive strategies, unscientific subjectivity, and its capacity to disrupt community consensus, and highlighted a broad range of potential consequences for individuals, communities, and social systems. However, there were also major areas of divergence and tension in this literature base. Specifically, there was disagreement about what kinds of problematic content constituted "misinformation," and how misinformation should be identified or adjudicated, especially in cases of evidentiary uncertainty or legitimate scientific disagreement.

To our knowledge, this is the first review to examine both explicit and implicit definitions of misinformation and to center contemporary usages of the concept. The work identifies several key characteristics of health misinformation, as well as areas where further concept development is needed. The review highlights the need for explicit reporting around the operationalization of the term, implementation of standards for communicating evidentiary uncertainty, values-aligned and co-designed health communications, and continued concept development. Findings from this literature analysis will inform further stakeholder and integrative synthesis, with the goal of developing a more usable, inclusive, and responsive definition of health misinformation.

RR2-10.12688/hrbopenres.13641.2.