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A systematic review of communication interventions for countering vaccine misinformation

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A systematic review of communication interventions for countering vaccine misinformation

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- "63.29% of UK individuals using the internet for seeking health-related information." 2020

https://ec.europa.eu/eurostat/

- "health misinformation was highest on Twitter/X , with some studies citing 87% of posts contain misinformation." Kbaier D, Kane A, McJury M, Kenny I. Prevalence of Health Misinformation on Social Media-Challenges and Mitigation Before, During, and Beyond the COVID-19 Pandemic: Scoping Literature Review. J Med Internet Res. 2024

https://www.jmir.org/2024/1/e38786/pdf

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Have you come across health related information that you're not sure about?

Maybe it was something you saw in a social media post, TikTok video, or newspaper headline. Perhaps it was something that a friend said ...

If in doubt, check it out!

See the Misinformation UnMASKED post below

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Registered charities such as Cancer Research UK, British Heart Foundation, Diabetes UK and the National Autistic Society have freely available resources on their websites, and links to local support groups and initiatives.

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National and international health information

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National and international health information

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Gov.uk and WHO are the places to go to for up-to-date national and international health information such as news about disease outbreaks or epidemics, initiatives and travel advice.

https://www.gov.uk/

World Health Organization (WHO)

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Signpost patients to the NHS website for information, including the Health A-Z, and to find out more about NHS services such Find a GP or Pharmacy services:

NHS website for England - NHS

There is a collection of patient decision aids that provide evidence-based information about treatment, care and support options available to them, and the associated benefits/harms, to help patients consider what matters most to them in relation to the possible outcomes (including doing nothing):

NHS England » Decision support tools

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Promoting vaccination: the right approach for the right group

Vaccines protect individuals and society from infectious diseases. However, people vary in their acceptance; age, ethnicity, household income and other factors influence their willingness to be vaccinated. Research can identify ways to improve vaccine uptake in certain groups and reduce inequalities.

This Collection brings together examples of NIHR research on how to increase vaccine uptake. It explores how to engage and communicate effectively with different communities.  It provides useful information for those commissioning and delivering vaccination services.

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Promoting vaccination: the right approach for the right group

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Could research identify ways to promote vaccination? Find out more about research on how to increase vaccine uptake.

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How to combat misinformation in healthcare

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How to combat misinformation in healthcare

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How to combat misinformation in healthcare | The BMJ

Misinformation was already a worry before the covid pandemic and has only grown since. Kamran Abbasi asks the LSHTM’s Heidi Larson and Martin McKee what doctors can do about it.

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Misinformation-UnMASKED-checklist.pdf

A useful guide to checking the reliability of health information

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SMOG (Simple Measure of Gobbledygook) index 

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SMOG (Simple Measure of Gobbledygook) index 

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SMOG is a measure of readability - how many years of education the average person needs to have to understand a text.​

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What Is Smog Readability?

The SMOG (Simple Measure of Gobbledygook) grade is a measure of readability developed by G. Harry McLaughlin in 1969, recommended for use in healthcare. It was developed as an alternative for the Gunning fog index.

What Is Smog Readability Formula

Here is the SMOG readability formula for a passage of at least 30 sentences.

1.0430 × square root(total polysyllables × (30 ÷ total sentences)) + 3.1291

According to the paper, Assessing the Readability of Policy Documents: The Case of Terms of Use of Online Services, here are the approximate conversion between the education level and SMOG readability score:

How Can You Decrease Smog Readability Score?

You can decrease the score by using fewer words of three or more syllables.

What Is the Smog Readability Calculator?

This online tool can be used to calculate the Smog readability grade of a text using the formula. All you have to do is to type or paste the whole content you want to evaluate into the input above.

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SMOG Readability Calculator - SMOG Index

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The SMOG (Simple Measure of Gobbledygook) grade is a measure of readability developed by G. Harry McLaughlin in 1969, recommended for use in healthcare. It was developed as an alternative for the Gunning fog index. Here is the SMOG readability formula for a passage of at least 30 sentences.

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This tool helps you write in a simple and clear way for the average UK reading age

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The average reading age of adults in the UK in 9 to 11 years old. The information we write often has a higher reading age than this. This tool helps you write in a simple and clear way for the average UK reading age.

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NHS Digital service manual

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How we write - NHS digital service manual

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Everything we write follows these general principles.

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SaSH Production of patient communication and information policy

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SaSH Production of patient communication and information policy

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For Tools and guidelines available to help you create patient information refer to the Patient Information Workspace on the Trust Intranet

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SaSH Library writing patient information

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SaSH Library writing patient information

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SaSH Library checklist for patient information

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SaSH Library checklist for patient information

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Shared decision making | NICE guidelines | NICE guidance | Our programmes | What we do | About | NICE

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Supporting your shared decision making through our guidance and tools

We're working to help put it at the centre of the way care and treatment is given.

For people receiving care

The care and support you receive should be based on your needs and what matters most to you.

You have the right to be involved in decisions with your healthcare professional. You should be able to make those decisions together.

Patient decision aids support conversations and help patients make informed choices. We've developed several tools to support shared decision making for specific conditions.

Read more about making decisions about your care.

For people delivering care

We have worked with Keele University to develop an online learning package that supports the shared decision making guideline. It aims to give healthcare professionals the skills and knowledge to have conversations with the people they are caring for.

We've updated all our guidance to highlight the importance of balancing professional judgment and expertise with the needs and wishes of people receiving care.

Read more about making decisions using NICE guidelines.

Patient decision aids

PDAs help people make informed choices about healthcare. This considers their personal values and preferences.

Our process guide outlines how we develop our PDAs.

The framework is designed for people who use PDAs, whether they are patients or clinicians. It helps them determine if the quality of the PDAs is sufficient.

It includes a simple self-assessment tool for people who produce PDAs so that they can quality check their processes and products.

Shared decision making collaborative

We work with over 40 partner organisations. With them, we support the wider health and care system to put shared decision making into routine practice. The aim is to make sure that people who deliver and receive care work together to provide what matters to the individual.

Our joint recommendations to encourage a shared decision making culture can be read in our consensus statement (Word).

The organisations we work with include:

Academy of Medical Royal Colleges

Advancing Quality Alliance

General Medical Council

Health Education England

Healthwatch England

NHS England and NHS Improvement

Newcastle University

University of Leeds

To get involved or to find out more, contact our shared decision making team.

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Information and benefits about shared decision making. Includes links to patient decision aids.

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Which populations are more likely to be affected by having low health literacy?

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Which populations are more likely to be affected by having low health literacy?

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Are older​

Have a limited level of education​

Have mental health issues​

Have chronic conditions or disabilities​

Are living in poverty or low income/unemployed​

Have English as a second language ​

Have low information and technology skills

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NHS England » Decision support tools

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Decision support tools, also called patient decision aids, support shared decision making by making treatment, care and support options explicit. They provide evidence-based information about the associated benefits/harms and help patients to consider what matters most to them in relation to the possible outcomes, including doing nothing.

Decision support tools: making a decision about a health condition

These decision support tools are designed to support shared decision making between people and a clinician. People may find they are useful before, during or between consultations depending on their care pathway. For more information about how this tool was created, please email england.shareddecisionmaking@nhs.net

Cardiovascular

Medical

Ophthalmology

Orthopedics

Surgery

Women's health

These tools have been developed in accordance with The National Institute for Health and Care Excellence standards framework for shared decision making support tools, including patient decision aids.

There is also a very helpful short video that introduces the MSK DSTs including their purpose and content.

We will continue to build on this suite of tools and publish as they become available.

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Decision support tools, also called patient decision aids, support shared decision making by making treatment, care and support options explicit. They provide evidence-based information about the associated benefits/harms and help patients to consider what matters most to them in relation to the possible outcomes, including doing nothing.

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HLRP: Health Literacy Research and Practice is an interdisciplinary and international open-access publication dedicated to promoting excellence in research and practice to advance the field of health literacy, promote health equity, and reduce health disparities.

You can search for this and other journal titles here:

Surrey and Sussex Healthcare NHS Trust — BrowZine

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Available with NHS OpenAthens through Kortext - a multi-disciplinary collection of online books.

https://read.kortext.com/

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NHS England Health Literacy Toolkit​ ​

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Health Information - (library.nhs.uk)​

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Focuses on verbal and written communication; includes readability tools and guidance on producing information jargon-free.​

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Links to NHS England Health Literacy e-learning module and Misinformation UnMASKED​

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Health Literacy Geodata – prevalence estimates for local authorities.​

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https://healthliteracy.geodata.uk/

NICE (National Institute for Health & Care Excellence) Shared Decision Making​

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NICE Shared Decision Making​

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Background, guidance and tools, with links to NICE guideline and patient decision aids.​

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PIF tick

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Pif tick

Having the PIF TICK shows an organisation’s health information has been through a professional and robust production process.

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We need to reduce health inequalities by targeting individuals and communities where ill health and unhealthy lifestyles are the greatest, by empowering patients to protect and improve their own health through supported self-management and self-care, and by taking part in shared decision making.

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A 2022 HEE study found that the digital divide affects those who are older, poorer, unemployed, living alone or with a hearing or visual impairment, and that:

6 in every 100 UK households (6%) do not have internet access at home

5% rely solely on mobile internet access

c.2 million households have home internet access but struggle to pay for it

of those who do have access to a digital device and the internet, around 8 out of 100 people (8%) say they are not confident in using it

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Digital literacy means the ability to effectively navigate, evaluate and communicate information using digital technologies.

It helps facilitate:

Online/virtual consultations​

​Booking or amending appointments​

Accessing online patient portals​

Managing documents or images

Finding reliable health information online

The potential barriers to having Digital Literacy could be a general lack of confidence around using technology​, and the jargon and processes involved (eg. Apps, passwords) as well concerns around privacy and confidentiality.

There could be financial barriers - the cost of equipment, and paying for broadband and smartphone contracts, or maybe language barriers, traditional reliance on family/other helpers​, or disability.

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Trouble understanding instructions or communications

Issues around implementing changes to lifestyle

Medication either not taken at all or taken incorrectly ​

Wards unnecessarily full​ due to readmission

Inappropriate use of A&E​

Navigating hospital signage

Delays in clinics​

Low uptake of screening & vaccination programmes​

Financial and human cost of misunderstandings

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Percentage of the local population aged 16-65 that are BELOW threshold levels of health literacy and health numeracy​

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Estimated prevalence of low health literacy and health numeracy combined: Reigate and Banstead  50.61%

​ Estimated prevalence of low health literacy and health numeracy combined:  Crawley  62.77%

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It is estimated that low Health Literacy costs approximately 3%-5% of the total NHS budget; this would have​

equalled £5.7 - £9.6 billion in 2020-2021​

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‘Costs of low health literacy,’ Health Literacy Centre Europe (HLCE), 2015​

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43% of adults (16-65) do not have adequate literacy skills to routinely understand health information​

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61% of adults (16-65) do not have adequate numeracy skills to routinely understand health information​

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Rowlands G. et al, 2015​

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Because the healthcare system is complicated; written and spoken health information is complicated.​

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The needs of those with low health literacy are not always considered and the evidence base indicates a proven link between people's basic skills and their health outcomes; low literacy and numeracy skills are linked to poor health behaviours, QOL and life expectancy.

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“… is the personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health.”                                                ​

(WHO Health Literacy Toolkit 2014)​