The role of civic literacy in infodemic management

Earlier this year, in the midst of the COVID-19 pandemic, the World Health Organization (WHO) and its partners called for their Member States to develop action plans to promote science-based information and address the increasing impact of the ‘infodemic’ that continues to undermine the global COVID-19 response [1] and contributes to misinformation and low compliance with protection measures among many groups around the world. An interview with Dr. Sylvie Briand from WHO we published in our Journal in the first issue of 2020 also highlighted the severity of the ongoing infodemic and the role of risk communication in addressing misinformation and engaging communities in pandemic response [2]. More recently, WHO and its partners also unveiled a framework for managing the COVID-19 infodemic [3]. Among other calls to action, this work calls on ‘citizens from all parts of society [3]’ to demand and rely on evidence-based information, and take steps to protect themselves and others from misleading information on the pandemic.

As defined by WHO, an infodemic is ‘an overabundance of information, both online and offline. It includes deliberate attempts to disseminate wrong information to undermine the public health response and advance alternative agendas of groups and individuals [1].’

Over the years, misinformation on social media, mass media, and within many other online and offline community and population health settings, has contributed to vaccine hesitancy and refusal, misleading anti-cancer screening messaging, unsubstantiated claims about diet and nutrition, and fake news during Ebola and Zika outbreaks in different world regions [4], among many other topics. This editorial argues that – similar to other political and social processes – infodemics are interdependent on civic literacy and civic engagement levels, and that therefore high rates of civic literacy and engagement may be important protective factors against misinformation and also help patients, healthcare professionals, communities and their leaders select and prioritize information.

Several authors [5–7] have discussed that in many countries, social and political processes – such as those in support of democracy – have been negatively affected by a decline in civic literacy and civic engagement, ‘which are pivotal to the health of communities [5].’ Recent attacks on science and other anti-science feelings during the ongoing COVID-19 pandemic should also be considered attacks on social and democratic processes as they ‘pollute’ information and communication systems, contribute to mistrust among many communities, and deprive more vulnerable citizens from essential evidence-based information that would allow them to protect themselves, their loved ones, and their communities.

Civic literacy, which is not only the understanding of political processes and government functions, but arguably should also include caring for truth-stating claims, empathy for our fellow citizens, and the ability to understand and discern the impact of policies on our own lives, is an important determinant of civic engagement [Civic engagement is defined here as ‘involving collective action to address problems or to promote specific interests within communities [5]’]. In fact, civic engagement is also ‘the process of creating better-informed citizenry so that people from different professional sectors and communities can effectively contribute to policy and economic decisions that ultimately affect their lives[8]’. Finally, as an important factor in promoting health literacy, as well as a key domain of established health literacy frameworks, civic literacy plays an essential role ‘in aligning personal health care decision-making with public health goals [9]’.

Engagement in our cities and communities should not be limited to activism, but should rather be a sustained community-based process in which citizens are committed to protecting each other and advancing shared goals. Across the world, citizens should have opportunities to consider engaging with community-based organizations in their neighborhoods, and effectively participate in advocacy efforts and strengthening communication and information systems. Such a process is very relevant to infodemic management during the COVID-19 pandemic, and requires an increased investment in promoting civic literacy, which is emerging as one of the most important skills and programmatic areas of our century.

Some efforts to increase civic literacy rates both domestically and globally already exist, especially in the form of courses and other training opportunities intended for students and faculty members [10,11]. These are two important groups in making sure that future generations are actively involved in infodemic management and refrain from carelessly spreading misinformation, conspiracy theories, and other misleading information on social media and other communication channels. However, the COVID-19 pandemic has added urgency to expand this work not only to the aforementioned groups but also to community members and their leaders as well as different kinds of institutions and organizations both in the for-profit and non-profit sectors. It is of great importance to connect these efforts with their relevance to public health and patient outcomes, and across existing interventions – which is not always the case these days.

In the era of social media, it’s also essential to ‘borrow’ from those who spread misinformation some effective communication strategies and approaches that seem to resonate with people. One that comes to mind is making sure that our new media-based interventions include, engage and feature peer, community, and religious leaders from the communities for which they are intended. Promoting media and civic literacy among those local leaders with an inclination for or the potential to champion humanity, decency, and evidence-based information, and equipping them with the skills they need to become powerful voices on social media and within other settings, are also strategic imperatives. New evaluation tools that account for the many barriers people experience to behavioral and social change should also be developed to assess the effectiveness of these and other current and future online and offline strategies. Finally, including vulnerable, marginalized, and underserved communities and patient groups in risk communication processes, and intervention and media design, and effectively institutionalizing community-based risk communication [12] are increasingly urgent action areas in the era of COVID-19.

In looking at 2021, we hope you will engage with our Journal on these and other related topics that are likely to continue to shape COVID-19 response and recovery and many other health, social, and human rights issues. Across research and practice, together, we can help shape these important agendas.

In this issue

This December issue of 2020 includes many articles and topics that resonate with this editorial and the crises of our times. First, I would like to highlight the interview with Naureen Navqi, MA, from UNICEF, which focuses on UNICEF’s work on building resilience and engaging communities to protect children and families during the COVID-19 response and recovery. Our Front Matter section also includes our first ever piece in our new Patient Voices occasional section, which aims to elevate patients’ perspectives in the discussion of healthcare communication and to disseminate lessons learned on a variety of topics by incorporating patients’ input. This section is edited by Dr. Thanakorn Jirasevijinda, Editor Emeritus and Special Section Editor at our Journal, to whom I am grateful for the initiative.

Our papers focus on a variety of current topics, including research insights on knowledge, attitudes and practices toward COVID-19 among Colombians during the outbreak; and a comparative study on knowledge and risk perception about Ebola virus outbreaks in Ghana and Liberia. Featured in this issue is also an article collection on patient-provider communication, which includes research and new models on this important health communication area.

The last issue of the year is always an opportunity to thank the many people who contributed to our efforts at the Journal. I would be remiss not to do so especially at these unusual times, in which everyone’s efforts have been doubled, given the pandemic and the many professional and personal challenges we are all experiencing. First, I would like to thank Radhika Ramesh, MA, Senior Editorial Assistant and Special Section Co-Editor, Interviews, for her many contributions throughout the year. Thank you also to the team at Taylor & Francis for their support during this transitional year and for their flexibility and encouragement.

Finally, thank you to our editorial board, reviewers, authors, and readers for their commitment to our Journal during these trying times. I hope 2021 will bring some advances and resolution to COVID-19 and other challenges from this past year. I wish you all a healthy and happy 2021! It has been good to be back at the Journal and to our professional community! Thank you all!