Frequent Hospital Users with Limited English are Vulnerable to COVID-19 Misinformation: Results from A Cross-sectional Survey

Abstract

BackgroundSuccessful public health responses to pandemics rely on individuals being able to access, clearly understand and easily interpret relevant information about symptoms, prevention, testing and containment strategies. Accessing and interpreting information during the pandemic has been difficult for many populations, particularly those experiencing social or economic disadvantage. The aim of this study was to understand how a population of frequent hospital users originating, from a disadvantaged population, have accessed and interpreted information during the COVID pandemic in Melbourne.MethodsCross sectional telephone survey of 200 frequent hospital users (115 with limited English proficiency) informed by the World Health Organisation’s “Rapid, simple, flexible behavioural insights on COVID-19”. Primary outcome measures included knowledge of symptoms, preventive strategies, government restrictions aimed at containment, and belief in misleading information. Secondary outcome measure was perceived trustworthiness of information which was measured using content analysis of open-ended questions. ResultsOverall, the survey participants had poor understanding of misleading information (69%). 41.2% were unable to accurately identify symptoms, while 35.8% were unable to identify preventative strategies. Just under 1/3 (30.2%) were unable to describe government restrictions. English-speaking participants were almost three times (OR 2.69, 95%CI 1.47;4.91) more likely tohave adequate knowledge about symptoms, were twice as likely to understand local restrictions (OR 2.10 95%CI 1.06; 4.19) and were 11 times more likely to recognise information that was misleading or incorrect (OR 11.52 95%CI 5.39; 24.60) than those with limited English. 50% of those surveyed stated that theytrusted all information that they read or heard, with on 20% stating that they were uncertain or untrusting of some information.ConclusionLimited English proficiency was strongly associated with inadequate knowledge of COVID-19 and much greater likelihood of believing widely circulating misinformation. In order to reduce transmission, morbidity and mortality associated with COVID-19, health authorities must tailor health messaging to disadvantaged populations to ensure they have adequate access, and understanding, of the information.