Community-oriented Motivational Interviewing (MI): A novel framework extending MI to address COVID-19 vaccine misinformation in online social media platforms

Researchers have linked circulating misinformation in online platforms to low COVID-19 vaccine uptake. Two disparate literatures provide relevant initial guidance to address the problem. Motivational Interviewing (MI) effectively reduces vaccine hesitancy in clinical environments; meanwhile, social scientists note inoculation, rebuttal, and appeals to accuracy are persuasive in digital contexts. A tension is inherent in these approaches. MI in digital forums may induce an 'illusory truth effect,' wherein falsehoods appear more accurate through repetition. Yet, rebutting misinformation directly may elicit backfire or reactance effects, motivating some to amplify their presentation of misinformation. Building on Identity Process Theory, we propose a theoretical framework for conducting MI-based infodemiology interventions among digital communities that conceptualizes the community in toto (rather than one specific person) as the unit of focus. Case examples from interventions on public Facebook posts illustrate three processes unique to such interventions: 1) Navigating tension between addressing commenters and bystanders; 2) Activating pro-vaccine bystanders; and 3) Reframing uncertainty or information individuals might find concerning or threatening according to implied collective values. This paper suggests community-oriented MI can maximize persuasive effects on bystanders while minimizing potential reactance from those with committed beliefs, thereby guiding community-oriented public health messaging interventions enacted in digital environments.

Automated summary

Researchers have found a link between circulating misinformation online and low COVID-19 vaccine uptake. Motivational Interviewing (MI) has been effective in reducing vaccine hesitancy in clinical settings, while inoculation, rebuttal, and appeals to accuracy have been persuasive in digital contexts. However, there is a tension between these approaches, as MI in digital forums may lead to an 'illusory truth effect,' and directly rebutting misinformation may elicit backfire effects. This paper proposes a community-oriented MI framework for digital interventions, highlighting the importance of addressing commenters and bystanders, activating pro-vaccine bystanders, and reframing information according to collective values.