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Characterization of misleading fluoride information on Instagram: An infodemiological study (Preprint)
Abstract
BACKGROUND
Digital oral health misleading information has been propagated on social media to deceive people about fluoride's economic and health benefits to prevent dental caries.
OBJECTIVE
This study aimed to characterize the misleading fluoride-related information on Instagram.
METHODS
3,863 posts ranked by users' total interaction and published between August 2016 and August 2021 were retrieved by CrowdTangleTM, of which 641 were screened to obtain 500 final posts. Afterward, two independent investigators analyzed posts qualitatively to define their authors' interests, profile characteristics, content type, and sentiment. Also, LDA topic modeling was applied to find salient terms and topics related to false content, calculating their similarity through an intertopic distance map. Data were evaluated by descriptive analysis, Mann-Whitney U test, Cramer’s V test, and multiple logistic regression models.
RESULTS
Most posts were categorized as misinformation and political-misinformation. The engagement of users was mainly associated with older messages (p<0.001; OR = 3.293) and professional-/political-misinformation (p=0.048; OR = 1.944). In this context, time from publication, negative/neutral sentiment, author’s profile linked to business/dental office/news agency, and social and political interests were related to the increment of the interaction performance of messages. While political-misinformation with negative/neutral sentiments was usually published by regular users, misinformation was linked to positive commercial posts. Overall messages focused on improving oral health habits, side effects, dentifrice-containing natural ingredients, and fluoride-free products propaganda.
CONCLUSIONS
Misleading fluoride-related posts on Instagram were predominantly produced by laypeople motivated by social, psychological, and/or financial interests. However, higher engagement metrics were associated with political-misinformation. Most posts were related to the toxicity of fluoridated water and products frequently motivated by financial interests.
Background
False messages on the internet continually propagate possible adverse effects of fluoridated oral care products and water, despite their essential role in preventing and controlling dental caries.
Objective
This study aims to evaluate the patterns of psychophysiological reactions of adults after the consumption of internet-based fluoride-related information and disinformation.
MethodsA 2-armed, single-blinded, parallel, and randomized controlled trial will be conducted with 58 parents or caregivers of children who attend the Clinics of Pediatric Dentistry at the Bauru School of Dentistry, considering an attrition of 10% and a significance level of 5%. The participants will be randomized into test and intervention groups, being respectively exposed to fluoride-related information and disinformation presented on a computer with simultaneous monitoring of their psychophysiological reactions, including analysis of their heart rates (HRs) and 7 facial features (mouth outer, mouth corner, eye area, eyebrow activity, face area, face motion, and facial center of mass). Then, participants will respond to questions about the utility and truthfulness of content, their emotional state after the experiment, eHealth literacy, oral health knowledge, and socioeconomic characteristics. The Shapiro-Wilk and Levene tests will be used to determine the normality and homogeneity of the data, which could lead to further statistical analyses for elucidating significant differences between groups, using parametric (Student t test) or nonparametric (Mann-Whitney U test) analyses. Moreover, multiple logistic regression models will be developed to evaluate the association of distinct variables with the psychophysiological aspects. Only factors with significant Wald statistics in the simple analysis will be included in the multiple models (P
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