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Fall 2024

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Navigating the Landscape of Conflicting Health Information: The Paradox of Progress

Hoda Fakhari, MS1; Savanna Kerstiens, MA1; Marleah Dean Kruzel, PhD2 - Health Decision Making and Communication SIG

Health guidelines published by respected organizations aim to provide patients and healthcare professionals with valuable information for medical decision-making by offering recommendations for clinical practice. However, with an increase in production of health guidelines from different sources and updates to these guidelines over time, a significant issue has emerged – conflict in the health information they present. This paradox of progress, whereby the very advancements in scientific knowledge create a landscape of conflicting information, poses a barrier to positive health behavior change.

Exposure to conflicting health information can lead to negative responses such as confusion, lower trust in scientists, and backlash toward health recommendations (Clark et al., 2019; Iles et al., 2022; Nagler et al., 2019, 2022). There are several types of conflicting information though they all may not be well-recognized. Conflicting health guidelines bring with them a unique set of challenges in that they can arise from comparable reputable sources or from the same source over time (Carpenter et al., 2016). An update to screening guidelines can be an example of asynchronous conflict, meaning there is conflict between older and newer propositions about an issue. For example, in April 2024, the United States Preventive Services Task Force (USPSTF) changed their breast cancer screening recommendation, advising screening to start at age 40 instead of 50, while maintaining the every-other-year frequency until age 74 (US Preventive Services Task Force, 2024). These types of conflicting recommendations about when and how often to receive cancer screening can leave patients feeling uncertain about which sources to use and trust (Housten et al., 2022). Moreover, conflicting information and evolving guidelines may diminish informed decision making and enthusiasm for cancer screening and increase cancer fatalism (Housten et al., 2022; Iles et al., 2022; Nagler et al., 2019).

What might conflicting guidelines mean for behavioral medicine researchers?

Despite awareness of conflicting guidelines, little work has been done to help healthcare professionals and patients navigate the complexities of these recommendations. How should healthcare professionals choose the guidelines to inform their clinical decision-making and share with patients? How can conflicting guidelines be communicated in a way that does not deter patients from protective health behaviors? To address these challenges, behavioral scientists and public health professionals must develop innovative solutions while considering key features in the study of conflicting guidelines. 

  • Context. Because health guidelines are created and maintained by reputable organizations, often shaped by policies, systems, and social norms, these factors need to be assessed in future behavioral medicine studies.
  • Mechanisms. The link between cognitive and affective responses to conflicting information and actual engagement in preventive behaviors is unclear. Behavioral medicine researchers have a valuable opportunity to assess how well health guidelines predict patients’ actions regarding disease prevention and screening.
  • Interventions. Existing research on communicating risk and uncertainty can inform development of interventions targeted toward healthcare professionals and patients to help mitigate the negative impact of conflicting health guidelines. For example, healthcare professionals can engage in open communication by acknowledging uncertainty and evolving health information, tailor recommendations to individual patients’ needs and preferences (e.g., health status, insurance coverage, resources, etc.), and partner with patients and healthcare administration to build trust.  

In summary, conflicting information is a prominent and realistically unavoidable feature of the health information landscape. As behavioral medicine researchers, it’s crucial that we understand how conflicting health information and guidelines make up information ecosystems and influence decision-making for both healthcare professionals and patients. We should design our studies and interventions on health behavior change with this in mind, incorporating measurements of these concepts into our research. By doing so, we can ensure that the paradox of scientific progress does not impede our work toward optimal health.

Affiliations

  1. School of Communication, Northwestern University
  2. Department of Communication, University of South Florida; Health Outcomes & Behavior Program, Moffitt Cancer Center

References

  1. Carpenter, D. M., Geryk, L. L., Chen, A. T., Nagler, R. H., Dieckmann, N. F., & Han, P. K. J. (2016). Conflicting health information: A critical research need. Health Expectations, 19(6), 1173–1182. https://doi.org/10.1111/hex.12438
  2. Clark, D., Nagler, R. H., & Niederdeppe, J. (2019). Confusion and nutritional backlash from news media exposure to contradictory information about carbohydrates and dietary fats. Public Health Nutrition, 22(18), 3336–3348. https://doi.org/10.1017/S1368980019002866
  3. Housten, A. J., Hoover, D. S., Britton, M., Bevers, T. B., Street, R. L., McNeill, L. H., Strong, L. L., Hersch, J., McCaffery, K., & Volk, R. J. (2022). Perceptions of Conflicting Breast Cancer Screening Recommendations Among Racially/Ethnically Diverse Women: A Multimethod Study. Journal of General Internal Medicine, 37(5), 1145–1154. https://doi.org/10.1007/s11606-021-07336-w
  4. Iles, I. A., Gillman, A. S., O’Connor, L. E., Ferrer, R. A., & Klein, W. M. P. (2022). Understanding responses to different types of conflicting information about cancer prevention. Social Science & Medicine, 311, 115292. https://doi.org/10.1016/j.socscimed.2022.115292
  5. Nagler, R. H., Vogel, R. I., Gollust, S. E., Yzer, M. C., & Rothman, A. J. (2022). Effects of Prior Exposure to Conflicting Health Information on Responses to Subsequent Unrelated Health Messages: Results from a Population-Based Longitudinal Experiment. Annals of Behavioral Medicine, 56(5), 498–511. https://doi.org/10.1093/abm/kaab069
  6. Nagler, R. H., Yzer, M. C., & Rothman, A. J. (2019). Effects of Media Exposure to Conflicting Information About Mammography: Results From a Population-based Survey Experiment. Annals of Behavioral Medicine, 53(10), 896–908. https://doi.org/10.1093/abm/kay098
  7. US Preventive Services Task Force. (2024). Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA, 331(22), 1918–1930. https://doi.org/10.1001/jama.2024.5534