Assessment of health misinformation in adult population: A cross-sectional study

INTRODUCTION

During any health emergency, there is often a surge of new information from multiple sources. This flood of data, varying in quality and the pace at which it is circulated, can have serious effects on both society and public health.^[1-4] Among the challenges are misinformation, which refers to inaccurate information shared without any harmful intent, and disinformation, which is deliberately shared to mislead the public. Another commonly used term is “fake news,” which describes misleading content presented as legitimate news. There is also the term “rumour,” which refers to information that has not been verified and may or may not be true. While these terms are used interchangeably, in this study, misinformation is used as a broad term covering any false or unverified information, regardless of whether it was intentional or not.^[5-7]

How do we describe entities spreading disinformation?

Threat actor: A person, organization, or entity that seeks to cause harm intentionally through its actions. Different threat actors include nation states, organized crime groups, extremist groups, activist influencers, and partisan media.^[4]

Social media has simplified the way people communicate and exchange information on various subjects, including health. However, the rapid spread of misinformation on these platforms often leads to an “echo chamber effect,” where people mostly see information that supports their current beliefs. This strengthens false narratives and makes it difficult for evidence-based information to spread.^[8,9]

In recent years, health misinformation has become a major concern on social media, powered by growing distrust in institutions, the rapid spread of digital platforms, and increasing public health emergencies. The COVID-19 pandemic brought the issue into focus due to the serious consequences misinformation had on individuals and communities.^[5] During the pandemic, false health information has led some people to refuse vaccines, reject public health measures, turn to unproven treatments, and engage in harassment and violence against health workers and other frontline workers.^[10-14] During COVID-19, the World Health Organization commissioned an “Evidence Gap Map” to assess all the evidence available since January 2020, focusing on infodemic management interventions.^[4]

There are several forms in which health misinformation spreads, such as memes, statistics, web articles and blogs, graphs and diagrams, quotations, old images, edited videos, and links to web pages with health misinformation. People who create and share such misinformation may have different motives. They may be disinformers, hoaxers, enthusiasts, casual sharers, mischief-makers, believers, or oversharers.^[4]

Social media users often share their personal experiences with health issues, suggest remedies, or give lifestyle advice. However, this type of information is typically based on individual opinions, which lack scientific evidence and are sometimes driven by commercial motives, such as the advertisement of any supplement. These practices can contribute to the spread of health misinformation.^[8,15-17] Confirmation bias also plays a role, as people tend to seek out information that supports what they already believe.^[18,19]

Another concern is that both accurate and false health information often uses specialized medical terms and concepts, thus making it difficult for normal people to understand or form informed opinions fully.^[8,20] According to the deficit hypothesis, people who believe misinformation often lack sufficient knowledge or literacy to tell the difference between what is true and what is false.^[21,22] In this case, the knowledge gap prevents the users from recognizing false claims.^[23] These distinct traits of health misinformation and its serious consequences raise the question, are current strategies to combat misinformation enough? And, alternatively, are other solutions needed? Accordingly, the study aims to assess user awareness, response patterns, and potential needs for designing future interventions.

MATERIAL AND METHODS

A cross-sectional study was conducted from January 2025 to February 2025. Participants for the study were chosen from different societies and working professionals, using a simple random sampling method in Gwalior city. A self-administered questionnaire designed as a Google Form was utilized to assess the knowledge, awareness, and response of the population towards health misinformation, which included open-ended questions as well as agree/yes or disagree/no response options. It was validated and pretested before the survey, with a Cronbach alpha value of 0.85. The use of artificial intelligence, for example, ChatGPT, was done only to improve language proficiency. Considering the increasing tendency for individuals to seek health-related information on social media, we selected participants who were students or employees and active on at least two social media platforms.

RESULTS

The questionnaire as shown in Table 1 was distributed to 256 participants, and responses were received from 202 as shown in Graph 1, resulting in a response rate of 78.91%. The study population comprised both males and females, with a male-to-female ratio of 124:78, and the mean age of the participants was 24 years.

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Graph 1:

Represents participant responses to questionnaire items.

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94.4% of the overwhelming majority believe that health misinformation causes harm either directly or indirectly. Thus, a high level of awareness can be seen about the dangers posed by misinformation. In contrast, 5.6% of participants denied that it affects individuals.

44.4%, i.e., nearly half of the respondents, admitted they may have unknowingly spread misinformation in support of a person or cause; this shows that unintentional spread is a significant concern. Meanwhile, 55.6% denied sharing such misinformation.

77.8% of a significant majority believe that some misinformation is purposefully created with an agenda. This points to a mistrust in certain media narratives and highlights concerns about manipulation. On the other hand, 22.2% did not agree with the statement.

77.8%, i.e., most respondents, claimed to rely on legitimate sources, showing a cautious approach to information. However, the remaining 22.2% of a notable fraction still place trust outside such sources, which may present a vulnerability to misinformation.

55.6% of participants agreed that uncertainty and lack of clarity among the public create breeding grounds for false information, whereas 44.4% responded in a neutral manner.

88.2% of a large majority indicated that during a health crisis, they actively look out for more information, most likely exposing themselves to both helpful data and misinformation. In contrast, 11.8% denied doing so.

72.2%, i.e., most respondents, believe that every new disease outbreak gives rise to misinformation. This trend likely arises from initial uncertainty, fear, and a rush to understand the unknown.

88.2% expressed strong support for collaboration between public health officials and independent fact-checkers. This reflects public demand for verified, trustworthy health communication to counter false narratives. Meanwhile, 5.9% disagreed, and another 5.9% were unsure.

94.1% of respondents widely recognized that misinformation destroys trust in science, government, and health authorities, whereas 5.9% did not agree.

70.6% of the majority agreed that combating misinformation is not solely the responsibility of health agencies but requires participation from all sectors - media, education, technology, and the public. However, 29.4% were unsure about what measures should be taken.

For 94.4% of participants, social media is seen as the dominant source of misinformation, pointing to its role in rapid and unfiltered information dissemination. For 5.6% of sources other than social media, such as news channels and newspapers, they were considered more responsible.

DISCUSSION

Our study focuses on health misinformation, but it also sheds light on a broader affair about how people respond to and perceive the ways misinformation is being handled. The result suggests growing awareness among users about the serious consequences misinformation can have on both individual and community health. The finding highlights the need for stronger rules and regulations and better content moderation, as people demand reliable and fact-checked information online. Overall, the data show that people are not only concerned about the impact of health misinformation but are also open to supporting proactive, collaborative solutions to fight it.

A deeper understanding of the psycho-socio-emotional drivers of misinformation acceptance and sharing, and how they differ across various domains, will be crucial for designing successful interventions.^[24]

Every group in society has a role to play in stopping the spread of false or misleading health information:

Individuals can play a vital role by learning to recognize misinformation, avoiding its spread, and helping correct false claims within their communities.^[5,8]

Educators should promote evidence-based educational programs and educate both students and the public on how to identify common tactics used by those who spread misinformation.^[5,8]

Health workers are trusted sources of information and can help by addressing patients’ questions, correcting false beliefs, and engaging in fact-checking – both online and offline.^[4]

Journalists and media professionals should fact-check health claims, respond to public concerns, and actively amplify accurate information while debunking and prebunking falsehoods.^[5,8]

Technology platforms need to monitor and detect misinformation early, proactively address information deficits, and ensure that credible health information is visible and accessible.^[5,8]

Researchers can play a key role by studying how misinformation spreads, assessing its impact, and evaluating which strategies and policies are most effective in combating it.^[5,8]

Community leaders can act as bridges between the public and health authorities by sharing community questions, concerns, identifying misinformation trends, and promoting trusted health sources and voices.^[4]

Governments must invest in misinformation research, establish best prevention strategies, modernize public health communications, support state-level efforts, and strengthen long-term resilience against misinformation.^[5,8]

In addition to the critical partners to combat misinformation, counter-disinformation requires important partners, including:

Law enforcement, intelligence agencies, non-governmental organizations, academia, and international organizations UN and non-UN (e.g., European Union).^[4]

CONCLUSION

The study concludes that after the pandemic, there has been a significant rise in the awareness of the dangers of health misinformation among people, as it somehow impacts their lives. Some misinformation is purposely created with an agenda to disintegrate trust in government and its authorities. Unintentional spread is still a concern; however, access to clear, reliable, and verified information is needed. Addressing this issue requires a coordinated, all-hands-on-deck approach, since people will keep looking for information during any health emergency. That means improving information literacy, encouraging evidence-based education, promoting trusted faces and voices from the community, and making sure that media and tech platforms share accurate health information would definitely make a difference. Public–private partnerships, empowering healthcare workers, supporting research, and raising public health awareness are all essential steps. With a united effort, we can control health misinformation and protect the health and well-being of our communities.