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How Belief systems/misinformation
are effecting the healthcare services?

The coronavirus disease (COVID-19) has been recognized as one of the fast spreading infectious outbreaks of the recent times. In such situations, assessing the knowledge concerning the myths of the disease is crucial.

Introduction

"Research is to see what everybody else has seen, and to  think what nobody else has thought."

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Coronavirus disease (COVID-19) caused by novel coronavirus has emerged as a global pandemic in the past few months. The contagious nature of this virus has led to a public health crisis, with the World Health Organization (WHO) declaring it a Public Health Emergency of International Concern on January 30, 2020.

To begin with a nationwide lockdown was enforced from 25 of March to interrupt the chain and “flatten the curve” of COVID-19 infection. Introduction of Aarogya Setu mobile application to educate citizens about novel coronavirus facilitates them in making informed decisions amid the crisis. Social media campaigns to educate public on physical distancing, hand hygiene, personal protection, etc., are some of the implementation measures undertaken by Government of India.

Facilitating outbreak management of COVID-19 urges a need to understand the public’s awareness of COVID-19. Prevention of such outbreaks largely depends on how the population accepts it and behaves that successively is influenced by what individuals apprehend and believe about the disease.

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Literature Review

Other relevant research in this area

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Systematic Reviews Methodology

A systematic review methodology answers a defined research question by collecting and summarizing all empirical evidence that fits pre-specified eligibility criteria.

Objective

To make individual studies to one overview. If you ask us Why? we are doing... then possibly it solves major chunks in literature review, when a group is involved in reading and reviewing on particular chosen literature question/ topic. Majorly, it provides following benefits to adopt

 

- Makes complexity of information smooth

- Increases precisions of estimates

- Resolve discrepancies

Process

INCLUSION & EXLUSION CRITERIA: Here, we will decide what type of article we will look for. Example It depends sometime our research more over towards knowing Behavioral part, Age groups, Demographically etc. Why? we do it, to eliminate the biases of literature research.

Define the question

BUNCHES OF LITERATURE:

Once we get the unbiased directions for literature, there after we start recording and finding same directed information from different resources like: books, internet, online search engines, medical websites, smaller journals, unpublished research, ask experts, newspaper articles, bibliographies, e-books etc.

Conduct a literature research

READING THE ABSTRACTS AND APPLYING INCLUSION & EXCLUSION CRITERIA:

Basically, we need to decide which article one to keep or not. By every individuals researchers reviews but to break the individua biases, we should review as multiple reviewers.

Pull articles read abstracts apply I/X

PULLING OUT DATA OUT OF DATA: Now, we can make either spreadsheet or table of content for unbiased data and information under major headings, such as Culture, behavior etc.

Data abstraction

START READING THE ACTUAL SELECTED ARTICLES:

Again, we are going to use inclusion & exclusion methods by every individuals researchers reviews but, to to break biases, we should review as multiple reviewers.

Read full articles apply I/X

CONCLUSION:

Evaluating the results or outcomes of research on Heterogeneity. Making it useful for further Primary researches like questionnaire, surveys, one to one interactions etc. to validate the findings authentic or not?

Conduct analysis

Grouping of Inclusion Notes

COVID 19/ Pandemic

Awareness

Digital healthcare

Medicines

Diet/food

Hygiene

Immunization

Nutrition

Fitness

Ageing

Privet Hospitals

Public Hospitals

Trendy Believes

Brand trust

Vaccine efficacy

Spreaders

Vaccination

Side effects

Physique/ body building/ fitness

Geographical perception

Allopathy vs. homeopathy

Cultural Believes

Home remedies

Family & traditional believes

Trustworthiness on elders advices

Superstitions

Side effects

Religious gurus & groups

Shyness to get tested

Community biases

Behavioral

Carelessness

Biological clock

Hygiene

Age groups

Ignorance

Home care attitude

Impatience

Awareness

Laziness

Half knowledge

Doctors biases in health within society

Self assessment

System failure & greed

To benefit businesses

Political

Propaganda

Unawareness of authenticated channels

Trustworthy Results

Lack of Govt. intention on awareness

Media & medium

Influencers/ celebrities

Digital healthcare

Social media

Open ended health information on internet

Fake and doctored information & videos

Youngsters as netizens

Reading out full paper as multiple reviewers and pull out data out of it!

In previous step, We have selected papers/ articles and any sort of relevant related info. by applying Inclusion and exclusion method. Now, here we will look upon our selected information as deep studying as multiple reviewers and then will find out all possible insights for coming at any valuable conclusion.

Business & the Economy

- We classify messages

 under business and

 economy when messages

 relate to scams, panic-

 buying and target

 businesses with fake

 positive cases.

- The majority of

 misinformation here is

 intended to create some

 form of panic such as

 stories about essential

 commodities

 disappearing, fake

 shutdown notices of

 businesses and cash

 shortages.

Cure, Prevention & Treatment

- We see two distinct trends – first is that of home remedies (including terms such as lemon, vinegar etc.) and alternative medicines (Ayush, herbs etc). While cure-related misinformation was very significant early in the COVID spread, it gradually fell with the passage of time, since the remedies did not work, and they reached a saturation point, to use a COVID metaphor, there was herd immunity to some of the claims of alternative cures as it became increasingly clear from official sources that there was none

- We find that cure-related misinformation has a higher share of institutional attribution to support its claims. An official-looking logo and letterhead are used to make the claim seem real.

Casualty

- Message under casualty

 when they refer to

 fear-invoking messages

 related to deaths,

 suicides and suffering

 of people in the

 pandemic. These

 messages are distinct

 from death statistics

 in that they deal with

 the viscerality of the

 condition, such as

 descriptions of

 symptoms, visuals of

 death and suffering

 etc, intended to cause

 distress in the viewer.

Government

- We classify here messages have that purport to have government announcements and advisories and refer to police, judiciary and official institutions.

- As we see, there is a significant component of tweets about the police, much of which is about police brutality, posts about which increased significantly after the lockdown began, and some legitimate news of police attacks on citizens started to surface.

- In terms of legitimating claims of misinformation related to government agencies, governments or politicians, who can be projected as having inside information on the story, are frequently used, where doctored visuals of an interface from a news source alongside a claim that Narendra Modi himself proposed an internet shutdown.

Culture

- As the coronavirus

 spread increased in

 India, religious

 references appeared in

 increasing numbers

 later. Muslims became

 an important part of

 the misinformation

 spread as spreaders of

 the coronavirus and

 provokers of chaos and

 violence, following the

 Nizamuddin Markaz

 incident.

- A frequently seen

 feature of culture-

 related misinformation

 is that they often rely

 on the use of a

 publicly recognized

 figure to grab

 attention of the

 reader. Yoga master

 Baba Ramdev is

 presented to give

 credence to a

 misinformation claim

 that makes a cultural

 reference at Ayurvedic

 / Hindu practices.

Doctored statistics

- Messages that have exaggerated numbers of positive cases or death counts and fake advisories. A look at the word cloud shows that institutions are often used to substantiate claims. Thus UNICEF, WHO or specifics about places where the statistics are from are cited to make them more believable.

Methodology

Primary Research

It is also called field research is collecting data that is created during the time of study. We have included, Questionnaires, Interviews and Direct observations.

Objective

By using this method, anyone can collect this information by himself/ herself. It reduced the dependency on secondary research as literature review. Reliability is more than secondary. Also, provides up to date information & insights. Main objective to use this method:

 

- To define intent

- To know context

- To know user

- It help in framing insights

- Best way to explore concepts

- Easy to build plans

- For smooth delivering

How we used this method

It is a research tool that made up of a number of questions. It is designed in a way for statistical analysis. Also, to identify respondents attitude, experience, and behavior towards the subject of research.

Questionnaires

It is also called directed storytelling. Guided storytelling is interview technique, participants been ask to describe their experiences and thoughts on a specific topic.

Interviews guided storytelling

Questionnaire Responses

Myth & misinformation Awareness Survey Results

A total of 97 respondents participated in the study. Of which 49.48% (48) were female 50.52% (49), male with around 93.81% (91) belonging to the age group of 18–30 years, and the rest belonging to the other age group categories. Majority of the study population were either undergraduates (36.08%) or postgraduates (59.79%).

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Demographic profile of respondents

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Distribution of internet users in India 2019, by age group

Around 54 percent of the Indian internet user base was between 20 and 29 years old according to a survey conducted in 2019. People over the age of 40 formed the lowest share, while youngsters in the age group of 16 to 19 years made up about 17 percent share of the total internet user base. India had over 560 million internet users that year, ranking second in the world in terms of the number of people with internet access. Among the total internet users in the country, it was found that around 70 percent users were male and only about 30 percent were female users.

Self-assessment Test on 18-30 years

For each correct response, a score of 1 was assigned. Mean score for each question and overall mean score for the incorrect responses were calculated to categorize into low and high levels of incorrect knowledge, lower score signifying higher incorrect knowledge.

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Analytics Insights

1. 67.03% respondents believes Antibiotics

   & antivirals effective against COVID 19,

   among that 36 (66.66%) are

   Postgraduates, 22 (66.66%) are

   Undergraduates.

3. Half of respondents are not aware with

   knowing WHO & Govt. of India myths/

   misinformation facts, such as "Pregnant

   women can transmit the virus to the baby

   inside" and "People with Diabetics,

   hypertension more likely to acquire the

   COVID than those without any other     

   problems.

2. 71.42% responses are comfortable in

   taking multivitamins and immune boosters

   for protecting COVID. Whereas 72.22% are

   Postgrads and 69.69% are Undergrads.

4. Average percentage of respondents in Q6,

   Q7, Q8 AND Q9 are likely to be 85.5%,

   who believes and understands "Eating

   garlic, turmic, ginger, or applying

   can't only way to prevent COVID".

   Similarly, misinformation and myths like

   warm weathers, hot bath and spraying

   alcohol are help only way to get away

   from COVID.

Assessment report on Responses Scores

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Analytics Insights

1. In total of 91 responses, 19%

   Approx. responses are able to

   scored more than 83% in given

   self assessment test of 12

   questions, where each questions

   carrying 1 marks each. Among

   total responses, 10 (55.82%) are

   from Postgraduates & 06 (35.29%)

   are from Undergraduates.

2. 52 responses out of 91, which

   approximately 57.14% scored

   average range scores, not more

   than 83% and less than 58%.

   Among 53 responses, 32 (61.53%)

   respondents are Postgraduates &

   17 (32.69%) are Undergraduates.

3. Least scorers are more than

   highest scorers, 22 respondents

   are scored lest in self

   assessment test. 24.17%

   responses were still more than

   19% approx. responses who scored

   more than 83% (Which is likely

   to be 10, 11 and 12 out of 12

   marks respectively).

Behavioral mapping respondents of 18-30 years

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Analytics Insights

1. 42.22% male respondents averagely

   uses Instagram to get  COVID related

   information. Whereas 50% female are for

   same.  Also, 30% of respondents among

   who have scored more than 83% in self-

   assessment test feels Instagram as main

   sources for  COVID Info. Around 50%

   least scorer uses Instagram as also

   their  main sources

3. 47 respondents out of 91 are likely to

   read up Newspapers for COVID

   Information, which accounts 52%

   approximately. Well  high, moderate and

   least scorer are 50% averagely using 

   Newspaper platform.

5. Twitter has been least used for COVID

   information, around  13.18%

   respondents seen engaged.

   Approximately 10% and 9.4%  used by high

   scorer and medium scorer responses

   respectively. Although, 20.83%

   respondents of low scorer uses Twitter

   for  information.

7. Facebook came as one of the least

   preferable platforms for  respondents

   with only 9 (9.8%) out of 91. Out of 20

   high scorer  respondents just 1 (5%) is

   accounted to be using Facebook as also 

   one sources for information in COVID.

   Similarly, medium and low  scorers are

   with 11.32% and 8.33% respectively.

2. Approximately, 72% of respondents prefer

   to watch News  Channels for COVID

   sources. Both male and female shares

   the  same ratio to follow this

   platforms. 67% Average of all scorer of 

   respondents are prefer to watch News

   Channel.

4. WhatsApp majorly used by least scorer

   and medium  scorer as 25% and 17%

   respectively. Whereas High scorer 

   respondents accounts for only 10% using

   this platform. In total,  only 19%

   approximately among 91

   respondents using  WhatsApp as COVID

   info. platform.

6. 26 (28.57%) out of 91 respondents also

   uses Newsletters as  a COVID information

   sources.  Medium scorers accounted by

   30%  using it and 16.6% by low scorers,

   20% by high scorers.

8. 25.27% believes word of mouth as their

   sources for  information.  Whereas Low

   scorers and Medium scorers are 

   preferred sources with 05 (22.72%) and

   16 (30.76%) respectively.  High scorers

   are least with only 02 respondents. 

8. Only 2% approximately, respondents go

   with PIB/ WHO  Guidelines and

   websites as their main sources for

   COVID  Information.

Mixed Sources for Information related to COVID 19

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Analytics Insights

1. Instagram, Newspapers, News Channel:

 

   20 (22%) Respondents are together on

   these platforms to get  COVID

   Information.

   51 (57%) Respondents are averagely get

   somewhere from these three sources.

3. News Channels, Newspapers, Newsletters:

   18 (20%) Respondents are together on

   these platforms to get  COVID

   Information

   45 (50%) Respondents are averagely get

   somewhere from these three sources.

2. Instagram, WhatsApp, Newsletters:

   06 (07%) Respondents are together on

   these platforms to get  COVID

   Information.

   34 (38%) Respondents are averagely get

   somewhere from these three sources.

4. Instagram, Word of mouth, Newsletters:

   10 (11%) Respondents are together on

   these platforms to get  COVID

   Information.

   30 (33%) Respondents are averagely get

   somewhere from these three sources.

Observant, Authentic & Responsible

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Analytics Insights

1. Those respondents who are likely, comfortable in re- sharing COVID posts and messages freely on social media platforms. Also, don't mind on  checking authenticity of any of he/his posts/ messages/ news related with covid before sharing it to many. These respondents are put government as  one key factor on not delivering factual information like "banging of the pans" etc

- Only 2% approximately, respondents agrees with above said intentions, Where 01 (2%) and 01 (2.5%) are male and female respondents  respectively.

- Among all, 02 (3.7%)  responses are from postgrads and in it half male and female agreed for same.

- Whereas No High scorers think agrees on above markings, unlikely medium scorers have 01 (2%) and Low scorers 01 (4.5%) agrees  respectively. Also, no female in medium scorer respondents and no male in low scorer respondents been sighted for agreement.

2. Following information and stats on respondents comfortability and uncomfortable on re- sharing the post, messages etc. of COVID on social  media platform :

- 17 (18.68%) respondents are comfortable, among this 7 (15.55%) male and 10 (21.73%) female. In this, Undergraduate are 06 (18% approx.)  and postgraduates are 11 (20% approx.). On scores parameter, 32% approx. respondents are low scorer, 15% are medium scorer and 12% are high  scorer

- 74 (81.31%) respondents are Uncomfortable, 38 (84.44%) male and 36 (78.26%) female. Whereas, high scorer are 88.02%, medium scorer are  84.61% and low scorer are 68.18%. 

3. Information and stats on respondents Authenticity and Unauthenticity of COVID on sharing social media platform :

- 76 (83.51%) respondents are better to aware with their authenticity of contents of COVID information. Female are forward than male, 39 (84.75%)  female and 37 (82.22%) male knowing the authenticity

- 15 (16.48%) respondents are not bother with checking authenticity and unauthenticity while sharing COVID information on social media platform. 

4. Information and stats on government as one key factor on not delivering factual information :

- 61 (67.03%) out of 91 respondents said "Yes" on knowing unknowingly the myths/misinformation delivered by government of India. Among this,  33 (73.33%) are male and 27 (58.69%) are female. Subsequently, 30 (32.96%) respondents said "No" to knowing the "Banging of plates, utensils  etc." as myths/misinformation, out of 30 respondents- 12 (26.66%) are male and 19 (41.30%) are female

- Out of 33 undergraduates, 23 (69.69%) said, "Yes" and 10 (30.30%) said, "No". Similarly, 36 (66.66%) respondents from postgraduates said  "Yes" and 18 (33.33%) said "No".

- Whereas, low scorer who said "Yes" are 13 (59.09%) out of 22 respondents, medium scorers are 37 (71.15%) out of 52 and highest scorer are  11 (64.70%)  out of 17 said "Yes" too.

Sensitivity & Knowledge

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Analytics Insights

1. Out of 91 respondents, 36 (40%) approx.  respondents are don't believe on any  channel for Authenticated COVID related  information. In 30 respondents, 18 are male  and 18 are female. Whereas, 23 (42%) approx.  Postgraduates are unable to find the right  platform, 12 (36.3%) Undergraduate are  feeling the same.

2. Approximately, 19 (20%) respondents  have trust on platforms like- WHO, NDTV &  other News channels, Health Ministry,  AIIMS Website, Govt. Websites, CoWins. for  COVID related information. 

3. 18 out of 52 respondents , 10 out of 22  respondents and 08 out of 17 respondents from medium scorers, lower scorers and  highest scorers respectively, are not aware or  have authenticated channel and way to get  COVID information.

Interviews Guided Storytelling

Planning the structure of the interview

People, platform and context will help us to understand the purpose and exact boundaries for proceeding interviews.

Context

Myth/ misinformation stories as Individuals experience of himself or other ones. Based on following directions:

- Own believes on choosing and suggesting?

Behavioral living pattern on seeing things randomly

Sensibility/ responsibility towards systems, channels

  and institutions etc.

Awareness of pandemic

Cultural influence

Questions and formats

Stories

Targeted Age Group

At least 8 respondents from 18-24 yrs. and 25-30 yrs. age group respectively.

Interview platform

Zoom and Instagram

Results and findings

1. Improper Medication due to lack of authentic knowledge

Its been found that respondents are very much aware with their regular activities like kadha, but main cause are founded in taking up medication especially in choosing medicines like Antibiotics, multivitamins, antivirals, immune boosters etc.

4. Least uses of authenticated Platforms for COVID information

Instagram, Newspaper, News Channels are the most used platforms by respondents to get COVID information. Whereas, lest scorers prefers mostly, Instagram, WhatsApp, Twitter, Word of mouth. Also, Least uses of platforms like PIB, WHO, Govt. Websites by respondents.

7. Lack of authenticated information on social platforms

Information related to COVID spread on social platforms are highly unauthenticated and nor trustable. Very less people have way to some authenticated informational channels.

2. Unaware with Authenticated COVID 19 Channels

More than half respondents aren’t aware about the information, that was strictly implemented or proposed by WHO and Government of India.

5. Lack of connection between people & Institutions such as Govt.

Respondents mostly get to know myths/misinformation through social channels but, most of the time they have struggled with Government, institutional counterpart. Due to lack of reach in between respondents and institutions, Govt. channels etc.

8. Don't mind myths/misinformation

People mostly don't want to talk about myths/misinformation, at individual level most of us is careless with delivering and learning of COVID information.

3. Unconfident Respondents

Majority of respondents scored medium and low, even low scorers are more than higher scorers. Averagely respondents are looked much unaware with myths/misinformation.

6. Institutional Trust Issues

Our institutions are week in establishing themselves as trustable among us. Most of the people have mixed thoughts with Government implementations and approaches, low scorers found to fall under most.

9. Orthodox approach in society

Mostly people are following some of their ancestral orthodox behaviors for copping out with COVID. Age groups like 18-30 years are not even question and unfollow these orthodox practices.

Results and findings

The findings of this study suggest that the health authorities need to focus on the vulnerable population who have shown high levels of incorrect knowledge this might most likely ensue to restricted access to internet and online health information resources. Hence, the authorities and health-care employees need to target such population and provide them with the correct information which might facilitate in prevention and transmission of the disease.

Research Team:

Amit Kumar | G Shankar | Abhishek Yadav | Kuldeep Panjri | Ranjana

Research Report

Mentor Faculty: 

Hari Kishan Nallan (Chief Design Officer at Think Design)

Duration:

2 Weeks