Patterns of Media Use, Strength of Belief in COVID-19 Conspiracy Theories, and the Prevention of COVID-19 From March to July 2020 in the United States: Survey Study.

Holding conspiracy beliefs regarding the COVID-19 pandemic in the United States has been associated with reductions in both actions to prevent the spread of the infection (eg, mask wearing) and intentions to accept a vaccine when one becomes available. Patterns of media use have also been associated with acceptance of COVID-19 conspiracy beliefs. Here we ask whether the type of media on which a person relies increased, decreased, or had no additional effect on that person's COVID-19 conspiracy beliefs over a 4-month period. We used panel data to explore whether use of conservative and social media in the United States, which were previously found to be positively related to holding conspiracy beliefs about the origins and prevention of COVID-19, were associated with a net increase in the strength of those beliefs from March to July of 2020. We also asked whether mainstream news sources, which were previously found to be negatively related to belief in pandemic-related conspiracies, were associated with a net decrease in the strength of such beliefs over the study period. Additionally, we asked whether subsequent changes in pandemic conspiracy beliefs related to the use of media were also related to subsequent mask wearing and vaccination intentions. A survey that we conducted with a national US probability sample in March of 2020 and again in July with the same 840 respondents assessed belief in pandemic-related conspiracies, use of various types of media information sources, actions taken to prevent the spread of the disease and intentions to vaccinate, and various demographic characteristics. Change across the two waves was analyzed using path analytic techniques. We found that conservative media use predicted an increase in conspiracy beliefs (β=.17, 99% CI .10-.25) and that reliance on mainstream print predicted a decrease in their belief (β=-.08, 99% CI -.14 to -.02). Although many social media platforms reported downgrading or removing false or misleading content, ongoing use of such platforms by respondents predicted growth in conspiracy beliefs as well (β=.072, 99% CI .018-.123). Importantly, conspiracy belief changes related to media use between the two waves of the study were associated with the uptake of mask wearing and changes in vaccination intentions in July. Unlike other media, use of mainstream broadcast television predicted greater mask wearing (β=.17, 99% CI .09-.26) and vaccination intention (β=.08, 95% CI .02-.14), independent of conspiracy beliefs. The findings point to the need for greater efforts on the part of commentators, reporters, and guests on conservative media to report verifiable information about the pandemic. The results also suggest that social media platforms need to be more aggressive in downgrading, blocking, and counteracting claims about COVID-19 vaccines, claims about mask wearing, and conspiracy beliefs that have been judged problematic by public health authorities.

Romer D ，Jamieson KH 《JOURNAL OF MEDICAL INTERNET RESEARCH》

Conspiracy theories as barriers to controlling the spread of COVID-19 in the U.S.

The COVID-19 pandemic poses extraordinary challenges to public health. Because the novel coronavirus is highly contagious, the widespread use of preventive measures such as masking, physical distancing, and eventually vaccination is needed to bring it under control. We hypothesized that accepting conspiracy theories that were circulating in mainstream and social media early in the COVID-19 pandemic in the US would be negatively related to the uptake of preventive behaviors and also of vaccination when a vaccine becomes available. A national probability survey of US adults (N = 1050) was conducted in the latter half of March 2020 and a follow-up with 840 of the same individuals in July 2020. The surveys assessed adoption of preventive measures recommended by public health authorities, vaccination intentions, conspiracy beliefs, perceptions of threat, belief about the safety of vaccines, political ideology, and media exposure patterns. Belief in three COVID-19-related conspiracy theories was highly stable across the two periods and inversely related to the (a) perceived threat of the pandemic, (b) taking of preventive actions, including wearing a face mask, (c) perceived safety of vaccination, and (d) intention to be vaccinated against COVID-19. Conspiracy beliefs in March predicted subsequent mask-wearing and vaccination intentions in July even after controlling for action taken and intentions in March. Although adopting preventive behaviors was predicted by political ideology and conservative media reliance, vaccination intentions were less related to political ideology. Mainstream television news use predicted adopting both preventive actions and vaccination. Because belief in COVID-related conspiracy theories predicts resistance to both preventive behaviors and future vaccination for the virus, it will be critical to confront both conspiracy theories and vaccination misinformation to prevent further spread of the virus in the US. Reducing those barriers will require continued messaging by public health authorities on mainstream media and in particular on politically conservative outlets that have supported COVID-related conspiracy theories.

Romer D ，Jamieson KH 《-》

Conspiratorial thinking, selective exposure to conservative media, and response to COVID-19 in the US.

Previous research has shown that during the early months of the COVID-19 pandemic in the US, users of conservative media were more likely to accept conspiracy theories about the pandemic and less likely to accept pandemic mitigation measures such as mask-wearing and vaccination. To test the hypothesis that during the first year of the pandemic, viewers who were prone to conspiratorial thinking engaged in selective exposure to conservative media which served to enhance pandemic-related conspiracy beliefs. A national 3-wave longitudinal survey of 883 US respondents running from March to November 2020 assessed media-use habits, belief in COVID-related conspiracies, conspiratorial thinking, mask-wearing, intention to accept a COVID vaccine, and trust in the Centers for Disease Control and Prevention (CDC). Growth curve models were used to analyze changes in conspiracy beliefs and associated public health outcomes. Users of conservative media were disproportionately likely to engage in conspiratorial thinking, to vote for President Trump, and to be ideologically conservative. They were also less likely to use mainstream news sources and displayed increasing belief in pandemic conspiracies. Increases in conspiracy beliefs were associated with reduced support for pandemic prevention. Although users of conservative media supported vaccination and trusted the CDC at the outset of the study, continued exposure to conservative media reduced support for both. Increasing use of mainstream print was associated with less endorsement of pandemic conspiracy beliefs. Viewers of mainstream television news did not exhibit change in pandemic conspiracy beliefs over time. Conservative media in the US have attracted users prone to conspiratorial thinking and conservative political views who are also less exposed to mainstream news. The selective use of these media enhances belief in conspiracies that pose challenges to the country's ability to control a public health crisis such as the COVID pandemic.

Romer D ，Jamieson KH 《-》

Investigating and Improving the Accuracy of US Citizens' Beliefs About the COVID-19 Pandemic: Longitudinal Survey Study.

The COVID-19 infodemic, a surge of information and misinformation, has sparked worry about the public's perception of the coronavirus pandemic. Excessive information and misinformation can lead to belief in false information as well as reduce the accurate interpretation of true information. Such incorrect beliefs about the COVID-19 pandemic might lead to behavior that puts people at risk of both contracting and spreading the virus. The objective of this study was two-fold. First, we attempted to gain insight into public beliefs about the novel coronavirus and COVID-19 in one of the worst hit countries: the United States. Second, we aimed to test whether a short intervention could improve people's belief accuracy by empowering them to consider scientific consensus when evaluating claims related to the pandemic. We conducted a 4-week longitudinal study among US citizens, starting on April 27, 2020, just after daily COVID-19 deaths in the United States had peaked. Each week, we measured participants' belief accuracy related to the coronavirus and COVID-19 by asking them to indicate to what extent they believed a number of true and false statements (split 50/50). Furthermore, each new survey wave included both the original statements and four new statements: two false and two true statements. Half of the participants were exposed to an intervention aimed at increasing belief accuracy. The intervention consisted of a short infographic that set out three steps to verify information by searching for and verifying a scientific consensus. A total of 1202 US citizens, balanced regarding age, gender, and ethnicity to approximate the US general public, completed the baseline (T0) wave survey. Retention rate for the follow-up waves- first follow-up wave (T1), second follow-up wave (T2), and final wave (T3)-was high (≥85%). Mean scores of belief accuracy were high for all waves, with scores reflecting low belief in false statements and high belief in true statements; the belief accuracy scale ranged from -1, indicating completely inaccurate beliefs, to 1, indicating completely accurate beliefs (T0 mean 0.75, T1 mean 0.78, T2 mean 0.77, and T3 mean 0.75). Accurate beliefs were correlated with self-reported behavior aimed at preventing the coronavirus from spreading (eg, social distancing) (r at all waves was between 0.26 and 0.29 and all P values were less than .001) and were associated with trust in scientists (ie, higher trust was associated with more accurate beliefs), political orientation (ie, liberal, Democratic participants held more accurate beliefs than conservative, Republican participants), and the primary news source (ie, participants reporting CNN or Fox News as the main news source held less accurate beliefs than others). The intervention did not significantly improve belief accuracy. The supposed infodemic was not reflected in US citizens' beliefs about the COVID-19 pandemic. Most people were quite able to figure out the facts in these relatively early days of the crisis, calling into question the prevalence of misinformation and the public's susceptibility to misinformation.

van Stekelenburg A ，Schaap G ，Veling H ，Buijzen M ... -  《JOURNAL OF MEDICAL INTERNET RESEARCH》

COVID-19 conspiracy beliefs, health behaviors, and policy support.

Conspiracy theories have been proliferating during the COVID-19 pandemic. Evidence suggests that belief in conspiracy theories undermines engagement in pro-health behaviors and support for public health policies. Moreover, previous work suggests that inoculating messages from opinion leaders that expose conspiracy theories as false before people are exposed to them can help to prevent belief in new conspiracies. Goals of this study were to: (a) explore associations between COVID-19 conspiracy beliefs with SARS-CoV-2 vaccine intentions, cooperation with public health recommendations, and support for public health policies among U.S. adults and (b) investigate trusted sources of COVID-19 information to inform strategies to address conspiracy beliefs. A cross-sectional, online survey was conducted with 845 U.S. adults in April 2020. Data were analyzed using analyses of variance and multivariable regressions. One-third (33%) of participants believed one or more conspiracies about COVID-19. Participants who believed conspiracies reported that their intentions to vaccinate were 3.9 times lower and indicated less support for COVID-19 public health policies than participants who disbelieved conspiracies. There were no differences in cooperation with public health recommendations by conspiracy belief endorsement in the multivariable regression analysis. Although there were some key differences in trusted sources of COVID-19 information, doctor(s) were the most trusted source of information about COVID-19 overall with 90% of participants trusting doctor(s). Doctor(s) may play a role in addressing COVID-19 conspiracy theories before people are exposed to them to promote COVID-19 prevention efforts.

Earnshaw VA ，Eaton LA ，Kalichman SC ，Brousseau NM ，Hill EC ，Fox AB ... -  《-》