Zachary C. Warner, MD, MPH1, Rodrigo Alvarez, MD1, Juan F. Gallegos-Orozco, MD2, Echo Warner, PhD, MPH3 1University of Arizona, Tucson, AZ; 2University of Utah, Salt Lake City, UT; 3University of Utah College of Nursing, Tucson, AZ
Introduction: Online health information is vastly unregulated and often contains mis- and disinformation. Early studies suggest misinformation is often shared on social media by individuals and organizations for a profit. We describe associations of hepatitis B affiliated misinformation with profitability on the social media platform Instagram, which has over one billion monthly users worldwide.
Methods: In December 2021, we searched for publicly available posts using the terms “hepatitis b” and “hep b”. We removed duplicates from the top 55 posts for each term and coded N=103 posts using a validated misinformation codebook with 72 variables including: engagement (e.g., number of likes), user characteristics (e.g., # of followers, # following), profitability (e.g., for profit, selling product or service), and claims with misinformation (determined by medical experts). We applied two-tailed z-tests, chi-square tests, and linear regressions to examine associations between profitability and misinformation (outcome).
Results: Nearly a quarter of posts (n=24, 23%) contained misinformation about hepatitis B and/or hepatitis B treatment. Misinformation posts had more engagement on average (1,599 likes vs. 970 likes, p< 0.01), were following more accounts (1,127 vs. 889, p=< 0.01), but had fewer followers (mean: 22,920n vs. 70,442, p< 0.001) than accurate posts. Nearly one-third of posts about hepatitis B referenced a conspiracy theory (30%), were for-profit (29%), and were selling a product or service (34%) through Instagram. Significantly more misinformation posts were for profit (47% vs. 14%, p< 0.01) and were selling a product or service (43% vs. 13% p< 0.01) compared to accurate posts. For-profit accounts (b=713, 95% CI 25-1401, p=0.04) and those selling a product or service (b=843, 95% CI 196-1490, p=0.01) were following significantly more accounts than their counterparts.
Discussion: Online health misinformation poses direct threat to patients and has broader reach and engagement than accurate information. Hepatitis B misinformation may exacerbate health disparities, given that financial incentives are difficult to distinguish, however our findings suggest that a high number of “following” accounts may be a marker for accounts seeking profitability off of Hepatitis B misinformation on Instagram. More research is needed to understand how exposure to health information can influence patient/caregiver behavior and downstream clinical and financial outcomes.
Disclosures:
Zachary Warner indicated no relevant financial relationships.
Rodrigo Alvarez indicated no relevant financial relationships.
Echo Warner indicated no relevant financial relationships.
Zachary C. Warner, MD, MPH1, Rodrigo Alvarez, MD1, Juan F. Gallegos-Orozco, MD2, Echo Warner, PhD, MPH3. C0498 - Financial Incentives Associated With Hepatitis B Misinformation on Instagram, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.
