Health Myths – False Beliefs, Just a Layman’s Problem?

Health myths or “fake news” in the sense of scientifically untenable statements are widespread because in the digital age it has never been easier to find information about health and share it via social media. When it comes to obtaining information, around 74.0% of the population are specifically looking for health information. In this way, many hope to be able to distinguish between correct and incorrect information. Around two thirds consult medical professionals (69.1%), while for 20.1% the Internet and 5.4% the family, friends or colleagues are the first point of contact (Baumann et al. 2020). The focus of interest is on disease symptoms/causes, medicines and medicines, information on healthy lifestyles, fitness and wellness as well as health myths (Link/Baumann 2020). The hope is that the information provided by healthcare professionals is accurate and evidence-based. Due to digital distribution, laypeople such as health-related experts, i.e. particularly trustworthy multipliers, are exposed to pseudoscientific information. Believing and sharing health-related myths can have negative consequences for your own health and the health of others. The popularity of health myths is due to the fact that, as unscientific alternative explanations, they present complex medical relationships in a way that is understandable to laypeople (Betsch et al. 2018). In this respect, the question is relevant as to whether experts are aware of their own knowledge gaps and uncertainties and communicate these transparently. The aim of the study was to find out to what extent health-related experts trust their knowledge of health myths

>> In order to find out whether experts and laypeople differ in their knowledge of health myths, myths were identified whose truth was verified using scientific studies. Finally, 12 health myths from a variety of areas (nutrition, exercise, addiction, vaccination, etc.) were included using internet research. Factors such as variety of content, frequency, timeliness and scientific verifiability (evidence) were relevant to the selection of the items, as there are no established scales for health myths. In addition, myths are subject to change, so the breadth of topics should avoid distortions caused by individual expertise. All myths queried can be refuted (Table 1). The questions were queried using true-false queries to ensure a favored answer. To determine whether the myths are as widespread among representatives of direct and indirect health professions as among representatives of non-health-related professions, a univariate analysis of variance was carried out. To assess possible overestimation, the level of certainty following each statement about a health myth was also asked using a 5-point Likert scale from -2 (very uncertain) to +2 (very certain). An overall value was determined from the sum of all safety items. The analysis was carried out using SPSS 24 (IBM, 2016).
The data collection took place on February 8th. until March 15, 2021 via the SoSci-Survey online platform. The sequence of myth retrieval was randomized and was therefore random in order to compensate for possible order effects. Since there is currently no validated questionnaire to record health myths, a questionnaire was developed and tested on test subjects who work inside and outside the healthcare system (n=12). In order to include those working both within and outside of the healthcare sector, recruitment was deliberately carried out via the online campus of the APOLLON University (approx. 3,700 distance learning students who predominantly work in the healthcare sector) and the EURO-FH (approx. 7,000 distance learning students who predominantly do not work in the healthcare sector).
Results
A total of 619 fully participated in the study, of which 42 were excluded because they did not provide information about their professional status. The final sample consisted of 577 test subjects. The des-
cryptic description of the so-
socio-demographic sample
characteristics is in Table 2
shown. The sample
(N = 577; w = 445; m = 129;
d = 3) divides with respect to
their professional health
in these three groups
pen: The first group (N = 181; w = 136; m = 43; d = 2) includes professions with direct
tem health related
(doctor, paramedic, etc.), in the second (N = 167; f = 134; m = 33; d = 0) professions with an indirect connection to health (healthcare clerks, etc.) and in the third (N = 229; f = 175; m = 53; d = 0) Occupations not related to health (motor vehicle mechanics, retail clerks, etc.). There were no group differences regarding gender and age. The majority of respondents (84.8%)
had a higher educational qualification. The median age of the entire sample was 35–39 years.
The results show that the professional groups with direct (M = 8.25; SD = 1.99), indirect (M = 8.52; SD = 2.04) and without health-related (M = 8.35; SD = 1 .85) do not differ significantly in terms of the correctness of the answers (F(2, 574) = 0.859;
p = 0.42). The professional groups differ significantly in terms of the perceived certainty of the answers (F(2, 574) = 6.945; p = 0.00). The response reliability in group 1 (direct health reference) was highest (M = 53.10; SD = 6.22), in group 2 (indirect health reference) it was second highest (M = 51.28; SD = 6.29) and in Group 3 (without health reference) was lowest (M = 50.67; SD = 6.68). The LSD test indicates that the direct health-related group differs significantly from both the indirect health-related group (p = 0.01) and no health-related group (p = 0.00) in terms of the certainty of their answer. The group with an indirect health connection does not differ in terms of safety from the group without a health connection (p = 0.37). The responses of the professional groups also differed significantly with regard to perceived health competence (F(2, 574) = 35.132; p = 0.00). Perceived competence was highest in Group 1 (M = 4.05; SD = 0.644), second highest in Group 2 (M = 3.89; SD = 0.680) and lowest in Group 3 (M = 3.51; SD = 0.698). The LSD test indicates that both groups with a health connection differ highly significantly from the group without a health connection (each p = 0.00). The health-related groups also differ significantly from each other (p = 0.03).
As Table 3 makes clear, groups 1 and 2 prefer conversations with medical professionals, health-related specialist literature (e.g. Pharmacy Review), scientific specialist publications (Bundesgesundheitsblatt, Lancet etc.) and websites of specialist organizations (RKI, WHO etc.) as the source of information. stronger than Group 3 without professional backgrounds. If there is no professional health connection, this group prefers conversations with relatives, friends and acquaintances, general magazines (picture of the woman, etc.) and other (social) media (e.g.) compared to health experts.
YouTube) as an information basis. With regard to the source of information, it should be noted that the answers refer to self-assessment, so the supposed knowledge may be based on other sources, i.e. it may have been retrieved from implicit memory.
Limitation and discussion
Despite a large sample, the study cannot be classified as representative with regard to the underlying (professional) knowledge. Generalized statements cannot be made. In addition, the gender ratio was unequally distributed. Female participants (77.1%) dominated, therefore gender bias cannot be ruled out. Although distortions cannot be ruled out with regard to the occupational group classification and educational status, the higher educational status of the test subjects tends to support the findings. In order to avoid misclassifications, concrete examples were given for the professional groups and sources of information. It should be noted that the evidence disproving the health myths varied in its “strength.” Accordingly, some health myths could be proven by meta-analyses or clinical studies, while other health myths could only be proven by weaker evidence. Despite limitations, the results show that members of health-related professional groups prefer reputable sources (scientific publications, websites of specialist organizations, etc.). In addition, prior health-related knowledge and reputable sources do not seem to protect against unchecked adoption of health myths, regardless of whether they are laypeople or professional or semi-professional actors. It is not new that doctors are also convinced by widespread medical myths (Vreeman/Carroll 2007). International studies confirm that the misconception does not stop at expert opinion. According to a study of teachers in Great Britain and the Netherlands, 48 and 46 percent of teachers surveyed, respectively, are convinced that humans only use 10 percent of the brain (Dekker et al. 2012; von Dijk/Lane 2020). Such findings are, among other things, attributed to the illusory truth effect (Hassan/Barber 2021). (Digital) media seem to be a significant influencing factor, consciously or unconsciously (Kanning et al. 2014). Even prior knowledge does not protect against illusions of truth based on information familiarity, as a study among children and adults showed (Fazio et al. 2015). The existence of health-related myths among experts makes it necessary
1) to find out in the future why even health experts believe false information and
2) find preventive solutions to dispel false beliefs.

Health myths are already so widespread and have been represented so often that they no longer seem to be recognized and questioned. Even if refuted, the greater familiarity makes it easier to recall the misinformation. This psychological phenomenon is known as confirmation bias or persistent bias.
Flow effect (“continued influence effect”) is known (Susman/Wegener 2021). Misinformation can be corrected through trusted people and fact-checking articles. Whether and for how long myths persist also depends on how misinformation is corrected (e.g. through comprehensible graphics, alternative causal explanations) (Nyhan 2021).
Conclusion and recommendations
“Health literature” should not focus on health-related literature
Limit competencies, but rather include the critical and reflective handling of health information by laypeople as well as health experts (already during training and further education). The critical and reflective approach to health information should - regardless of the target group - relate to the background to the emergence of health myths and psychological phenomena of human perception distortion. In view of the digital overstimulation and cognitive relief that offer easily prepared, untenable statements, it makes sense to offer fact checks for scientific information not only for laypeople, but also for health-related experts. Health information and the correction of health-related misinformation should be scientifically comprehensible, easily accessible, prepared in a “brain-friendly” manner and presented by credible representatives of the respective target group. Psychological findings to explain health-related myths should be used positively in health communication to strengthen credibility (with the help of interdisciplinary teams). Because repeated information increases familiarity, misinformation should be repeatedly corrected to reduce durability. This requires identifying particularly persistent health myths to drive increased efforts to disseminate accurate information. <<

background

Various theories and findings support the assumption that experts consider their knowledge to be reliable, even though they do not have sufficiently reliable information and therefore do not differ from laypeople in certain respects. Information overload means that complex scientific information has less and less impact. Because according to the choice overload hypothesis (Iyengar/Lepper 2000) or the paradox of choice effect (Schwartz 2005) or the too much choice effect (Scheibehenne et al . 2009) simple decisions often make people happier. Even among experts, emotional appeals and personal beliefs are often more influential than pure objective facts. The cause may lie in subjective health theories and cognitive dissonances that arise from questioning or relativizing knowledge learned over many years (Büchter/Albrecht 2021). Subjective health theories guide individual decisions as well as evidence-based facts and seem to be inseparable from facts in everyday life, neither for laypeople nor for health experts. This is not surprising, since people - consciously or unconsciously - often orientate themselves towards reference values n (anchors) of the past in accordance with the anchoring effect. This anchor orientation is justified by the serial position effect (“primacy recency effect”), according to which information is most likely to be stored when it is at the beginning (primary effect) or at the end of a presentation sequence (“receny effect”) (Myers 2014). The more often people are exposed to untenable information, the more true they are judged to be. According to the illusory truth effect (Begg et al. 1992; Hohlfeld 2020), the familiarity of information, i.e. the subjective degree of familiarity, is responsible for the fact that health myths are assessed as credible statements. In this context, Tversky and Kahneman (1973) speak of the availability heuristic. If information is cognitively readily available, it is judged to be true. According to Goldstein and Gigerenzer (1999), the recognition heuristic is often used by people because in many situations decisions are made unconsciously purely on the basis of the feeling of recognition. It would not be surprising if laypeople and health experts “fall for” health myths when they are cognitively readily available through multiple exposures. It is known that professions that perceive themselves as experts and are credited with expertise tend to overestimate their own knowledge and generalize their expert status. This can be seen, for example, in teachers (Cunningham et al. 2009) or in doctors (Berner/Graber 2008). Little is known about whether health-related professionals overestimate their knowledge.