Interestingly, when shown a TikTok video opposing the use of antibacterial soap, Jennifer found the source – immunologist and pharmaceutical scientist Morgan McSweeney, PhD – very believable even though he presents himself as very “Western”. She did not address the contradiction, but explained that seeing the information presented by a person in a video format was much more compelling than reading “faceless” articles online. She explained:
“[The video] confirm what I already believe. You know what this video makes me realize? : if these press articles [NaturalNews and MedlinePlus] were made “in person” by someone like that, who seems to know what he’s talking about, I’d be more inclined to follow him than read him. I need someone to be confident and actually sell it.”
In the previous example, the appearance of “trying to sell something” was cited as a reason not trust the source; in the most recent example, Jennifer contradicts this reasoning and praises Dr. McSweeney for taking on the role of a confident salesperson. While the medium (text vs. video) may be a contributing factor, as she claims, her assessment is also likely influenced by confirmation bias – our natural tendency to reject information that conflicts with our pre-existing beliefs. In this example, she appears to accept new information that validates her existing beliefs, which promotes natural remedies and alternative medicine, regardless of source/format.
In another part of the survey interview, Jennifer was asked which of five different sources on her screen – like her personal doctor, a family member or a celebrity – would be most influence their decision-making on a health issue (in this specific scenario, it was weight loss). In reflecting on the pros and cons of each source, she explicitly acknowledged the role confirmation bias plays in her decision-making process:
“Certainly not my family. I don’t trust anything they say. “Advice from your doctor”… I think if they have the same beliefs, I would say very influential. If it was a vegan doctor, I would say very influential, but if it was a doctor who said “you have to eat animal protein to live”, I would say not at all influential.
What are the implications of confirmation bias in the evaluation of health information?
As I reflected on what the six participants had shared with me, it became clear that four of the five MHL skills – access, production, identification And commitment – followed a relatively predictable pattern when controlling for demographic covariates that would normally be associated with certain responses (e.g., a younger participant was more likely than an older participant to produce media content, or a Democrat was more likely to trust a government website than a Republican). But as far as the skill labeled critical reasoning, it was difficult to reconcile their reasoning with the usual demographic determinants. It was as if the introduction of health topics/issues triggered a cognitive loophole. Did exposure to health information trigger a significantly different response process than other types of informational stimuli?
While transcribing the interviews, I heard participants process different stimuli in ways that ran counter to standard behavioral theories. I heard a physical connection to the decision-making process, a prevailing sense that on some level they were weighing personal risk more than the actual health information at hand – risk of irreparable bodily harm (this will the vaccine hurt me?), risk of radiation exposure or pain (do I really need a mammogram?), risk of being confronted with long held beliefs that may not be true (Anything that says “antibacterial” must be better at preventing disease!). I heard hesitations and musings as participants pondered their answers, but I also heard persistent attempts to twist the answers in a way that matched pre-existing beliefs.
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